The Role of Ultrasonography and Computerized Tomography in the Diagnosis of Pediatric Cystic Neck Swellings

Abstract

Objectives: This study aimed to evaluate the role of US and CT in the diagnosis of pediatric cystic neck swellings. Background: Pediatric cystic neck swellings represent a major group of lesions that have long been a challenge to both clinicians and radiologists. US is an inexpensive, bedside and noninvasive technique while CT is the imaging modality of choice in characterization and staging of deep neck spaces cystic swellings. Methods: This prospective study included 72 children suffering from neck swellings. Forty two patients were found to have solid neck swellings while 30 patients represent this study population. US examination of the neck was performed for all patients in order to determine the nature of the swelling (cystic or solid), identify its origin, morphologic features & size in contrast to CT neck examination. Results: Male to female was 17 to 13, their ages ranged from 2 days and 18 years with a mean age of 8.5 years. Salivary gland abscess was the most common cause of neck swellings (20%) & thyroglossal cyst (16.6%) & cystic hygroma, retropharyngeal abscess, 2nd branchial cyst (10%) for each & parapharyngeal abscess, non tuberculus lymphadenitis with cystic degeneration, colloid goiter (6.6%) for each. Thirteen patients out of thirty had cystic neck swellings of congenital origin including cystic hygroma, branchial cyst, dermoid cyst, ranula & thyroglossal cyst. Conclusion: US is the prime investigation for patients suspected of having cystic neck swellings and was the first step in the diagnosis while CT scan was a sensitive tool for imaging and we recommend it as a confirmative imaging method.