2022 Volume 49 Issue 5 Pages 371-379
High-frequency linear probes used in the head and neck region have high resolution and can observe fine structures. Therefore, ultrasonography in the head and neck region is highly useful. However, the anatomy of the neck is complex, and it is necessary to understand the anatomy of the neck for ultrasound evaluation. The neck is composed of multiple overlapping fascia, and blood vessels and cervical lymph node flow are in the layer between the shallow and deep lobes of the deep cervical fascia. Since most cervical lymphadenopathies and masses are located in this layer, the examiner should focus on this area during cervical ultrasonography. When determining whether a lymph node is benign or malignant, the internal structures of the lymph node are assessed using B-mode and Doppler ultrasound. Some metastatic lymph nodes show characteristic ultrasound images depending on the carcinoma, which is also helpful in predicting the primary site. Among benign lymphadenopathies, tuberculous lymphadenitis requires attention because it is difficult to distinguish and diagnose. The mode of metastasis or recurrence of head and neck cancer differs depending on the primary site. Furthermore, ultrasonography for follow-up of cervical recurrence after head and neck surgery should be performed with caution because the anatomy of the neck has changed significantly after surgery. Medical information such as surgical records and preoperative ultrasound findings can be helpful. These topics are discussed in detail in this text.
