Ultrasonography of the Neck

Owing to the anatomic complexity of the neck and the diver- sity of pathologic entities affecting it, the cervical region has long been of great semiological interest. Physical examination is an easy means of evaluating the size and origin of a solitary cervical mass, yet valid interpretation can prove difficult when the normal morphology of the neck has been altered; excellent examples are patients with extensive fibrosis or scarring secondary to previous irradiation or surgery. Like- wise, physical examination cannot assess the relations of a pathologic process to adjacent structures - e. g., invasion can- not be distinguished from simple displacement -and it is un- suitable for monitoring therapeutic efficacy, such as the re- sponse of metastatic nodes to medical management. Between physical examination, which remains fundamental, and exploratory surgical procedures, which are often the only means of obtaining indispensable anatomic proof for diagno- sis, lie a number of recent imaging techniques including com- puted tomography and magnetic resonance imaging using surface coils that provide invaluable information for the in- vestigation of cervical pathologies. Real-time ultrasonogra- phy occupies a privileged position because of its noninvasive- ness, rapidity, and reliability, especially when performed by a specially trained examiner.