68 - Imaging of the Head and Neck

Question 1

Role of plain films in head and neck imaging

Answer 1

Limited.

Imaging of cervical trauma, sinus disease.

Question 2

Role of catheter angiography in head and neck imaging

Answer 2

Limited.

Assessment of vascular tumours and emboli.

Question 3

Mainstay imaging modality of head and neck

Answer 3

CT.

Question 4

Good marker in the head and neck of pathology

Answer 4

Parapharyngeal fat space.

Displacement can indicate location of pathology.

Question 5

Two reasons why thyroid glands are hyperdense on CT

Answer 5

Contains iodine (iodine is put in contrast)
Very vascular

Question 6

Use of ultrasound in head and neck imaging
1
2

Answer 6

• Extensively used
–Thyroid
–Submandibular glands
–Lumps and bumps
–Carotid arteries

• Useful in ultrasound guided biopsies

Question 7

Tissue that MRI is bad at imaging

Answer 7

Bone.

Need to use something that emits ionising radiation (EG CT)

Question 8

When is nuclear medicine used to image head and neck?
1
2
3
4

Answer 8

Thyroid scans
Parathyroid scans
PET/SPECT scans
Bone scans

Question 9

Way to tell apart MRI T1 and T2 scans

Answer 9

On T1, grey matter is grey and white is white.

On T2, grey is white and white is grey.

Question 10

Best modality to image paranasal sinuses

Answer 10

CT

Question 11

Common imaging modality to image mandible and teeth

Answer 11

Orthopantomogram (OPG).

A plain film technique.

Question 12

Problems with imaging of thyroid

Answer 12

Normal cystic changes and cancers look very similar on imaging.

Question 13

Two main forms of thyroid cancers

Answer 13

Papillary and follicular.

Question 14

Two phases of Hashimoto’s thyroid disease

Answer 14

Initially antibodies to thyroid lead to overactivity (thyrotoxicity).
Eventually scars, depletes ability of thyroid to function (hypothyroid)

Question 15

Common initial presentation of lingual thyroid

Answer 15

Bleeding into oral cavity (very vascular organ)

Question 16

Modality of choice for imaging vessels of the head and neck

Answer 16

CT angiography

Question 17

Ultrasound analysis of stenosis

Answer 17

Should be a laminar, regular pulsatile flow (because of heartbeat).
If stenosed, will have more turbulence, be less regular

Question 18

Tumour that can be confused with a nasal polyp

Answer 18

Juvenile angiofibroma (very vascular, will bleed profusely if biopsied).

Question 19

Best way to image temporal bones

Answer 19

Thin slice CT scans.