Neck computed tomography in pediatric neck mass as initial evaluation in ED: is it malpractice?

Abstract

Computed tomography could be considered as the first diagnostic modality when an urgent surgical condition such as a deep neck infection is highly suspected.

Lessons learnt from the global iodinated contrast media shortage in head and neck imaging

“…47,48 Usually unnecessary, MRI or CECT is likely required whenever malignancy, transspatial locations or deep seated cervical infection (retropharyngeal space) are suspected. [47][48][49] The presence of symptoms such as torticollis, dysphagia or respiratory involvement should prompt consideration of cross-sectional imaging in such cases. Due to the longer scan times, MRI is more likely to require sedation or general anaesthesia than CT studies in paediatric practice; however, the tissue characterisation and separation of tissue planes remain superior.…”

“…The presence of symptoms such as torticollis, dysphagia or respiratory involvement should prompt consideration of cross‐sectional imaging in such cases. Due to the longer scan times, MRI is more likely to require sedation or general anaesthesia than CT studies in paediatric practice; however, the tissue characterisation and separation of tissue planes remain superior 47–49 …”

Deep neck space infection in the paediatric age group – a review

“…Prompt imaging like CT scan of the neck is required to rule out such congenital lesions and is helpful for adequate treatment. CT scan has the advantages of early and accurate diagnosis, which help for quick planning of treatment and for safe and appropriate drainage [24]. CT scan is an ideal investigation, which is suggested for all patients showing the symptoms and signs of DNSI for better diagnosis.…”

ACR Appropriateness Criteria® Neck Mass-Adenopathy

“…CT Neck. CT with IV contrast can be performed in children suspected of a having a malignancy or a deep neck infection that may require surgery [21,29,96]. CT has reduced or absent sedation requirements given the shorter examination time.…”

“…MRI Neck. MRI of the neck can be performed in children suspected of having a malignancy or a deep neck abscess that may require surgical drainage [21,29,96].…”