ACR Appropriateness Criteria® Neck Mass-Adenopathy

Imaging, Expert Panel on Neurologic

doi:10.1016/j.jacr.2019.02.025

Cited by 22 publications

(24 citation statements)

References 95 publications

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“…The American College of Radiology evidence-based guidelines recommend for the child with a neck mass outside of the parotid region or the thyroid, that neck ultrasound, CT with or without contrast, or MRI with or without contrast are all "usually appropriate", that is, "….indicated in the specified clinical scenarios at a favorable risk-benefit ratio for patients" [4]. Ultrasound is usually the first imaging modality in primary care [32] and allows delineation of mass anatomical location, size, consistency and vascularity [4,31,35]. Other advantages of ultrasound are availability (depending on operator expertise) and sedation not being required.…”

Section: Discussionmentioning

confidence: 99%

“…Non-contrast CT might still be useful especially in the setting of trauma to assess if the mandible and other facial bones are intact. Shorter scanning times mean that the need for sedation may be reduced or obviated [4]. Recommendations for MRI are similar to those for CT with contrast, that is, for children with possible malignancy or deeper infection when surgery is being considered.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical assessment and blood workup may need to be supplemented by diagnostic imaging. Ultrasound, computed tomography (CT) scanning and magnetic resonance imaging (MRI) scanning may all have a role to play for selected patients [4]. The optimal management of a submandibular abscess in this setting is unclear, but an initially conservative approach with antibiotic therapy is recommended [4] depending on the speed of progression, associated symptoms, and other identified injuries.…”

Section: Introductionmentioning

confidence: 99%

“…Ultrasound, computed tomography (CT) scanning and magnetic resonance imaging (MRI) scanning may all have a role to play for selected patients [4]. The optimal management of a submandibular abscess in this setting is unclear, but an initially conservative approach with antibiotic therapy is recommended [4] depending on the speed of progression, associated symptoms, and other identified injuries. Surgical management of abscesses is reserved for cases that are refractory to medical management and showing signs of spread particularly to the deeper neck spaces, risking airway obstruction.…”

Section: Introductionmentioning

confidence: 99%

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Acute Mandibular Swelling Following Blunt Trauma

et al. 2021

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Submandibular trauma is rare, particularly in children or with an intact mandible. Clinical assessment of a child with a neck mass may need to be supplemented by diagnostic imaging. The optimal management of submandibular abscess is unclear, but an initially conservative approach is recommended. We report a case of a 10-year-old girl with a blunt injury 2 days following a fall who presented with a fever and a large lateral neck swelling. Inflammatory markers were raised and antibiotics were commenced. A magnetic resonance imaging (MRI) scan led to an initial working diagnosis of a submandibular abscess. Over time she remained systemically well, and an ultrasound could not radiologically differentiate infection from a collection. The final diagnosis was a submandibular post-traumatic hematoma with a secondarily infected collection. The initial management and decision to transfer to a higher level of service was significantly aided by the availability of MRI scanning. This case report illustrates the diagnostic and therapeutic dilemma in evaluating and treating acute mandibular swelling following blunt trauma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute Mandibular Swelling Following Blunt Trauma

et al. 2021

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“…However, if imaging studies can help differentiate the diseases, appropriate diagnosis and treatment without additional risks may be possible. Among the imaging studies, US is considered the most appropriate initial imaging modality for evaluating pediatric cervical lymphadenopathy because it does not require sedation, does not expose the children to radiation, and is easily available 7,10,11 . Prompt and appropriate differential diagnosis of KD from infectious lymphadenitis using US is needed to avoid unnecessary invasive procedures and administration of inappropriate medication, especially in pediatric patients.…”

mentioning

confidence: 99%

Kikuchi Cervical Lymphadenitis in Children

Park

Kim

Ryu

et al. 2020

J of Ultrasound Medicine

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Objectives To investigate ultrasound (US) features of enlarged cervical lymph nodes (LNs) to differentiate between Kikuchi disease (KD) and other common types of infectious lymphadenitis in an East Asian pediatric patient population. Methods A total of 142 pediatric patients with KD and 45 patients with infectious lymphadenitis (suppurative lymphadenitis [n = 29], nontuberculous mycobacterial lymphadenitis [n = 9], and tuberculous lymphadenitis [n = 7]) were included. The clinical characteristics, laboratory results, and US features of LNs were reviewed. The area under the curve (AUC) from a receiver operating characteristic curve analysis was used as a diagnostic accuracy measure. Results A multiple clustered adjacent pattern, bilaterality, an even size, posterior neck involvement, no enlargement, an elongated‐to‐ovoid shape, homogeneous hypoechogenicity, a well‐defined margin, presence of an echogenic fatty hilum, no intranodal gross necrosis, increased perinodal fat echogenicity, and no increased echogenicity of the adjacent sternocleidomastoid muscle were significant US features of the affected LNs to discriminate KD from infectious lymphadenitis (P < .05). Homogeneous hypoechogenicity in KD showed the highest AUC (0.930) as a single variable (95% confidence interval, 0.88–0.96). The AUCs were increased in 3 combination models with 2 US features: homogeneous echogenicity and 1 of 3 other US features (increased perinodal fat echogenicity, 0.935; number of affected LNs, 0.947; and LN shape, 0.949). Conclusions Homogeneous hypoechogenicity of LNs was a significant US feature with the highest diagnostic accuracy in differentiating KD from common infectious lymphadenitis on a univariate analysis. In the combination model, US features of an elongated‐to‐ovoid shape and homogeneous hypoechogenicity showed the highest diagnostic accuracy.

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Imaging of the Salivary Glands

Lazor

Garratt

2023

The Milan System for Reporting Salivary Gland Cytopathology

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ACR Appropriateness Criteria® Neck Mass-Adenopathy

Cited by 22 publications

References 95 publications

Acute Mandibular Swelling Following Blunt Trauma

Acute Mandibular Swelling Following Blunt Trauma

Kikuchi Cervical Lymphadenitis in Children

Imaging of the Salivary Glands

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