Pictorial review Neck masses in children

Infants and children with neck masses frequently present to the radiologist for further evaluation. The role of the radiologist is to differentiate between conditions using imaging modalities such as ultrasound with colour Doppler, CT and MRI. Where appropriate, the radiologist will also stage lesions for management purposes and aid in guiding aspiration or biopsy. This paper presents a pictorial review of paediatric neck masses and their imaging features. Particular emphasis is applied to the anatomical site of the mass to aid in differential diagnosis. It must be emphasised that the radiological findings should always be interpreted in conjunction with the patient's age, the clinical history and the findings on physical examination. Neck masses are not uncommon in children. The most common aetiologies include congenital lesions and their complications, lymphadenopathy, vascular, inflammatory and malignant lesions. The role of the radiologist is to differentiate between these conditions using imaging modalities such as ultrasound (US) with colour Doppler, CT and MRI. US is useful to determine if a mass is cystic or solid and Doppler tells us if it is vascular. US should be considered as the first-line investigation because it is non invasive, does not require sedation and does not involve ionizing radiation (1). CT and MRI can then be used to determine the extent of the lesion and whether local invasion is present. Both CT and MRI can provide multiplanar images, however MRI will more effectively demonstrate the soft tissue characteristics of a lesion.