Diagnostic Utility of Multidetector CT in Neck Masses: Insights from a Tertiary Care Centre in Chennai

Abstract

Introduction:
Neck lesions are frequently encountered in both medical and surgical outpatient departments, necessitating precise localization and
characterization for optimal treatment planning. Multidetector computed tomography (MDCT) offers significant advantages,
including high-speed imaging, thin-slice collimation, and multiplanar reformation capabilities. These features, combined with its widespread availability, have made MDCT the diagnostic modality of choice for neck lesions. This study aims to evaluate the role of MDCT in detecting, characterizing, and assessing the extent of neck masses. Our findings underscore the efficacy of MDCT inproviding detailed anatomical and pathological insights, thereby supporting clinicians in devising targeted therapeutic approaches for patients with neck lesions. Objectives: This study aimed to evaluate the effectiveness of computed tomography (CT) in identifying and delineating the borders of neck masses. Additionally, it examined whether CT offers supplemental information beyond clinical examination by revealing the depth of tumor extension. Methods: Our institution enrolled 45 patients with suspected neck masses for a study utilizing contrast-enhanced computed tomography (CECT). The CECT images were analyzed both before and after the administration of a non-ionic intravenous contrast agent. The researchers concentrated on evaluating the enhancement patterns, signs of local invasion into adjacent tissues, involvement of nearby bones, and potential vascular invasion by the lesions. Results: The study evaluated the capability of MDCT to differentiate between malignant and benign neck lesions, with histological examination confirming the diagnosis in all 45 cases (17 malignant and 28 benign). MDCT misclassified one case of mandibular osteosarcoma (a malignant bone tumor) as osteomyelitis (bone infection), resulting in a single false negative. Despite this, MDCT demonstrated a high diagnostic accuracy of 97.5%.