Ultrasonography of the Neck

With contributions by numerous experts Owing to the anatomic complexity of the neck and the diver­ sity of pathologic entities affecting it, the cervical region has long been of great semiological interest. Physical examination is an easy means of evaluating the size and origin of a solitary cervical mass, yet valid interpretation can prove difficult when the normal morphology of the neck has been altered; excellent examples are patients with extensive fibrosis or scarring secondary to previous irradiation or surgery. Like­ wise, physical examination cannot assess the relations of a pathologic process to adjacent structures - e. g., invasion can­ not be distinguished from simple displacement -and it is un­ suitable for monitoring therapeutic efficacy, such as the re­ sponse of metastatic nodes to medical management. Between physical examination, which remains fundamental, and exploratory surgical procedures, which are often the only means of obtaining indispensable anatomic proof for diagno­ sis, lie a number of recent imaging techniques including com­ puted tomography and magnetic resonance imaging using surface coils that provide invaluable information for the in­ vestigation of cervical pathologies. Real-time ultrasonogra­ phy occupies a privileged position because of its noninvasive­ ness, rapidity, and reliability, especially when performed by a specially trained examiner.

Owing to the anatomic complexity of the neck and the diver­ sity of pathologic entities affecting it, the cervical region has long been of great semiological interest. Physical examination is an easy means of evaluating the size and origin of a solitary cervical mass, yet valid interpretation can prove difficult when the normal morphology of the neck has been altered; excellent examples are patients with extensive fibrosis or scarring secondary to previous irradiation or surgery. Like­ wise, physical examination cannot assess the relations of a pathologic process to adjacent structures - e. g., invasion can­ not be distinguished from simple displacement -and it is un­ suitable for monitoring therapeutic efficacy, such as the re­ sponse of metastatic nodes to medical management. Between physical examination, which remains fundamental, and exploratory surgical procedures, which are often the only means of obtaining indispensable anatomic proof for diagno­ sis, lie a number of recent imaging techniques including com­ puted tomography and magnetic resonance imaging using surface coils that provide invaluable information for the in­ vestigation of cervical pathologies. Real-time ultrasonogra­ phy occupies a privileged position because of its noninvasive­ ness, rapidity, and reliability, especially when performed by a specially trained examiner.