12.1 Radiology Of The Head And Neck

Question 1

Briefly describe the advantages and disadvantages of radiography?

Answer 1

– X Ray beam onto a plate detector
– Quick, Cheap, Readily Available, Low ionising radiation dose
– Low Contrast (see different things), 2D images

Question 2

Briefly describe the advantages and disadvantages of US?

Answer 2

– Handheld probe using soundwaves
– Cheap, No ionising radiation
– Operator Dependent, Limited by Bone
– Useful for thyroid and superficial soft tissue only

Question 3

Briefly describe the advantages and disadvantages of CT

Answer 3

– X Ray beam from passing through a doughnut shaped scanner
– Quick, Readily Available
– High Radiation Dose

Question 4

Briefly describe the advantages and disadvantages of MRI?

Answer 4

– Images acquired from within a magnet
• Usually shaped like a long tunnel.
– Best contrast, No ionising radiation
– Slow, Expensive, Limited availability

Question 5

When might radiographs be used to image head and neck?

Answer 5

• Minor skull trauma

– Not meeting NICE criteria for CT for head injuries. • Cervical spine trauma • Foreign bodies within neck

Question 6

When might US be used to image the head and neck?

Answer 6

• Thyroid evaluation 
• Superficial head and neck masses (low or
indeterminate malignancy 
• Superficial infection 
• Carotid doppler

Question 7

When are CT scans used to image the head and neck?

Answer 7

• Trauma – NICE criteria
• Acute focal neurological symptoms
– Particularly to evaluate for haemorrhagic strokes
• Malignancy
– CT Head not routine for non-melanoma staging.
– Neck for tumours which spread to neck nodes.
• Infection
• Angiographic imaging of the arteries and
veins.

Question 8

When is MRI used to image the head and neck?

Answer 8

• Best imaging of the brain
– Tumour evaluation
– Epilepsy 
• Cervical spinal cord traumatic injury 
• Head and Neck tumours

Question 9

What are the main lateral sutures?

Answer 9

Coronal suture (between frontal bone and parietal)
Squamous suture ( parietal and temporal )
Lambdoid suture (parietal and occipital )

Question 10

Where is the frontozygomatic suture?

Answer 10

Between the zygomatic bone and the frontal bone. Can be seen in the frontal plane and forms part of the orbit of the eye

Question 11

Where is the sagittal suture?

Answer 11

Between the 2 parietal bones at the top of the calvaria

Question 12

What markings can be seen on a normal radiograph of the skull?

Answer 12

Sutures

Vascular impressions

Question 13

Why is MRI not used as a first line investigation of head and neck injuries that are acute/ immediately life threatening?

Answer 13

As they take much longer ( 30 mins at least)