Ultrasonographic Diagnosis of Body Surface and Head and Neck

Abstract

Many patients visit outpatient clinics suffering from tumors of the body surface and the neck. Ultrasonography is very useful because it is noninvasive and can provide information in real time. There is a complicated array of various tissues in the neck including blood vessels, nerves, muscles, salivary glands, and so. It is important for us to understand the anatomy when performing ultrasonography. It is necessary for us to master the screening examination to scan the whole neck systematically to understand the anatomy. We select several parts of basic images in the neck such as the thyroid gland, common carotid artery, internal jugular vein, submandibular gland, mental region, parotid gland, and outside neck. Scanning results of these parts should be recorded. Many lymph nodes are depicted as flat, oval, low echoic masses of the clear border when we carefully scan the whole neck using ultrasonography. In the central part of the normal lymph node, we recognize a small, high echo part called the fatty hilum. We detect the bloodstream along the fatty hilum on color Doppler imaging. This normal lymph node structure is destroyed in metastatic lymph nodes of head and neck cancer as they swell. Therefore, ultrasonography allows the differential diagnosis of normal lymph nodes and metastatic lymph nodes. Other tumors often appearing in the neck include thyroid gland tumors, salivary gland tumors, neurogenic tumors, lipomas, cystic tumors, and hemangiomas. Since there are characteristic ultrasound images of each tumor type, it is necessary to discern the shape, onset site, and internal bloodstream in detail for accurate diagnosis. Inspection and palpation help the diagnosis of body surface and head and neck tumors.