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Computed tomography of the soft tissues and organs of the neck helps to visualize the muscles of the neck, the state of the thyroid gland and the lymph nodes in this area.
It is also used to study the hollow organs of the neck, such as the nasopharynx, trachea, esophagus. Computed tomography is one of the most informative methods for examining the cervical region. CT examination helps to detect malignant tumors, foci of inflammation, cysts, organ injuries, hematomas, the presence and location of a foreign body in the neck, as well as hyperplasia of the lymph nodes. The area being examined also includes the cervical spine.
Soft tissue CT of the neck is a test that takes very thin slices (3,5-5 mm) of the image of the neck, starting just above the level of the ears and ending just below the collarbone. This allows more accurate diagnosis of conditions associated with areas such as the nasal passages, mouth, throat, thyroid, and parotid glands.
A computed tomography (CT) scan uses a special X-ray machine to view organs and tissues inside the body in detail.
CT scans of the soft tissues and organs of the neck provide more detailed information about neck injuries, tumors, and other conditions than other types of x-rays. A CT scan can also show bones, soft tissue, and blood vessels in the same images.
Computed tomography scans the internal parts of the body. The pictures are more detailed than typical x-rays. During a CT scan of the neck, pictures are taken of cross sections or sections of structures in the body.
When contrast is used during a CT scan, the structures stand out even more. CT can help determine the diagnosis at an early stage. The doctor uses this information to determine the best treatment for the patient.
Application of CT of soft tissues and organs of the neck
Computed tomography is very informative for diagnosing diseases of the soft tissues and organs of the neck. In particular, this study is able to document tumor size, location and relationship to adjacent structures, and CT can demonstrate the pathways of tumor spread.
The use of intravenous contrast agent during the examination provides the best visualization of the vessels and thus improves the identification of key vascular structures.
CT does not provide a histological diagnosis and does not allow differentiation between benign and malignant processes.
CT is very useful for evaluating parotid tumors and is likely to replace traditional sialography for evaluating parotid salivary gland tumor pathology. However, sialography remains the procedure of choice for assessing inflammatory diseases of the salivary glands.
CT is extremely valuable for the evaluation and diagnosis of laryngeal carcinoma. Computed tomography provides better image fidelity for assessing cartilage damage and tumor growth in the peripharyngeal spaces.
The current limitations of using CT of the larynx are: motion artifacts, lack of dynamic information, inability to differentiate edema from tumor infiltration, lack of adequate characterization of mucosal surfaces.
CT of the soft tissues and organs of the neck is most useful in detecting metastatic adenopathy, especially in obese patients.
Reactive nodes, however, cannot be distinguished from metastatic nodes. Normal lymph nodes are usually less than 5 mm in diameter and reactive nodes are usually less than 15 mm in diameter. Large nodules with central necrosis usually indicate the presence of a metastatic lesion.
The role of CT in the evaluation of thyroid nodules is limited due to the accuracy of radionuclide and ultrasound diagnostic methods.
Indications for the study:
- the presence of anomalies of the neck organs;
- damage to the organs of the neck caused by trauma;
- malignant and benign neoplasms;
- metastasis to the lymph nodes;
- foreign bodies of the neck for subsequent planning of their surgical removal;
- neck cyst diagnosis;
- damage to the cervical spine;
- infectious diseases of the tissues of the neck (abscess, infiltrate, phlegmon);
- diverticula;
- damage to the vessels of the neck.
For computed tomography, a contraindication is pregnancy at any time due to the negative effect on the fetus.
Contraindications to the introduction of a contrast agent are:
- the development of a severe reaction to contrast in history;
- the presence of allergic diseases, bronchial asthma;
- the presence of hyperthyroidism;
- liver or kidney failure in severe form;
- period of pregnancy and lactation.
A CT scan uses x-ray technology and advanced computer analysis to create detailed images of the body.
Preparation for CT
It is allowed to eat light meals before a computed tomography of the neck organs. Drink plenty of fluids on the day of your scan. It is allowed to take medicines as usual.
Be sure to tell your doctor or CT specialist if there is a possibility of pregnancy.
Some items can interfere with CT images, so your doctor may ask you to remove items such as:
- any clothing with zippers or snaps;
- hairpins and jewelry;
- glasses;
- Hearing Aids;
- removable dental prostheses.
The patient will be asked to lie on their back with their arms at their sides and very quiet. The table on which the patient is located will drive into the scanner. The scanner will only be closed at head and neck level. The scanner is open at the back and front, allowing the patient to see. This procedure usually takes 15 to 30 minutes.
After this procedure, there are no restrictions for the patient. You can eat and drive as usual. If the study was conducted with a contrast agent, you need to drink six to eight glasses of water to flush it out of the body.
If a CT scan of the soft tissues and organs of the neck with contrast is planned, before introducing a contrast agent, it is necessary to clarify whether there is an allergy to any drugs or iodine, which is its basis. If the patient has had an allergic reaction to the contrast agent in the past, doctors will give medication to prevent a reaction to the contrast before the scan.
If you have comorbidities such as asthma, diabetes, heart problems, multiple myeloma, or kidney disease, your risk of reaction to contrast may be increased. For example, kidney disease makes it difficult to remove the contrast agent from the blood.
Because CT scans use x-rays, no other people are allowed in the room during the scan.
How scanning is performed
The specialist helps the patient to take the correct position on the CT scanner table. It is possible to use padded straps or tape to help keep the neck in the correct position.
During the scan, the patient will be inside the CT scanner. X-rays will pass through the patient’s body as the X-ray tube rotates around it. The machine will take pictures from many angles, forming transverse images (sections) of the neck.
The radiologist leaves the room and during the scan the patient will be alone in the room, but he can always see, hear and talk to him through a special feedback device.
The patient must remain still while the table is moved to the center of the scanner.
If contrast-enhanced testing is required, patients will receive contrast (X-ray dye) during the scan. Contrast makes tissues and blood vessels more visible to the doctor’s view on CT scans.
What does the patient feel during the scan?
The CT scan is painless, but the patient may experience some discomfort from being on the scanning table.
If contrast is used during the injection, the patient may notice a warm, blurry feeling. He may also feel a metallic taste in his mouth. These reactions are normal. They should leave within 1-2 minutes.
From time to time, the patient feels itching for several hours after the contrast is injected. It is necessary to inform the doctor about this so that he can prescribe the appropriate treatment.
You should also tell your doctor right away if you experience dizziness, shortness of breath, or shortness of breath after a CT scan with contrast, as this could be an allergic reaction. A doctor or nurse will be nearby during the scan to help the patient if necessary.
Who interprets the results and how to get them
A radiologist experienced in CT interpretation will review and interpret the CT images and send a detailed report to the physician who referred the patient for examination. And the doctor will talk with the patient about the results of computed tomography of the soft tissues and organs of the neck.