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Ultrasound of the head and neck

– beyond the thyroid .

Rhodri M Evans

Neck lump Clinic.

• Salivary glands.

• Lymph nodes.

• Thyroid nodules.

Ultrasound.

Imaging neck masses.

• Salivary glands

• Lymph nodes

• Cysts

Ultrasound

Salivary glands.

• Anatomy

Sublingual glands.

Sublingual Gland

Salivary glands.

• Stones.

• Salivary tumours.

• Extra – salivary tumours.

Parotid.

masseter

RMV

ECA

Parotid tumours.

• 80% parotid in origin

• (20% extra-parotid)

• 80% superficial

• 80% benign

• 80% pleomorphic adenoma

Extra – parotid masses.

20% of “parotid “ masses are extra-parotid in location

LT

RT

LT

Lymph nodes.

Normal lymph nodes.

Normal lymph nodes.

Normal lymph nodes.

Normal lymph nodes.

Lymphoma?

Lymphoma

Metastatic lymph nodes

Metastatic lymph nodes

Metastatic lymph nodes

Metastatic lymph nodes

Metastatic lymph nodes

Normal lymph nodes.

Normal lymph nodes.

Malignant lymph nodes.

Malignant lymph nodes.

Malignant lymph nodes.

Malignant lymph nodes.

Lymph Node Examination

3 4

5

6

7

8

9

10

1 2

Imaging neck masses.

• Cysts

Ultrasound : rules

Rules .

• Cysts look solid.

• Solids can look cystic.

Cystic mass – upper cervical.

• Second Branchial cleft cyst.

• Metastatic lymph node : S.C.C.

• Metastatic lymph node : Papillary

Carcinoma Thyroid .

Rules .

• Cysts don’t usually look like cysts.

• Cysts will invariably look solid.

• Cysts - Anatomy!

?

Imaging neck masses.

• Salivary glands

• Lymph nodes

• Cysts

Ultrasound

www.headandneckultrasound.co.uk