RadteraCT Soft Tissue Neck with Contrast
CT+ ContrastHead & Neck
Indications
- Neck mass, lymphadenopathy, suspected head and neck malignancy staging
- Deep neck space infection/abscess, retropharyngeal/peritonsillar abscess
- Salivary gland and thyroid pathology, evaluation of dysphagia/odynophagia
Patient prep
- 18-20G IV; check renal function
- Remove dentures/jewelry from field
- Coach to suspend breathing and avoid swallowing during scan; quiet respiration
- Supine, arms down, shoulders depressed
Contrast
Agentiodinated (iohexol 350 / iopamidol 370)
RouteIV
Dose~80-125 mL at 2-3 mL/s
TimingDelayed soft tissue phase ~60-90 s (not arterial) for mucosal/nodal/abscess enhancement; split-bolus or single-phase contrast-enhanced
Technique
- Supine, arms down, shoulders pulled down; head neutral, no swallowing
- Coverage skull base through thoracic inlet (carina if substernal extension/staging)
- 120 kV, dose modulation; sub-mm collimation
- Soft tissue recon 2-3 mm; coronal and sagittal reformats
- Contrast-enhanced soft tissue (venous) timing, not CTA timing
Series / Sequences
| # | Series / Sequence | Plane | Thickness | Notes |
|---|---|---|---|---|
| 1 | Axial post-contrast | axial | 2-3 mm | Soft tissue window; angled to hard palate to reduce dental artifact |
| 2 | Coronal reformat | coronal | 2-3 mm | Nodal levels, deep spaces |
| 3 | Sagittal reformat | sagittal | 2-3 mm | Airway, retropharyngeal space |
| 4 | Thin axial | axial | 1-1.25 mm | Reformats |
Key points
- Use soft tissue (venous) timing—~60-90 s—not arterial; improves nodal and abscess wall enhancement
- Angle gantry/reformats parallel to hard palate (or use angled reformats) to minimize dental amalgam streak
- Have patient avoid swallowing/breathing motion; quiet respiration distends piriform sinuses
- Cover skull base to thoracic inlet; extend to carina for thyroid/substernal/staging
- Rim-enhancing fluid collection with mass effect = abscess; report airway compromise
References
• ACR-ASNR-SPR-SRU Practice Parameter for the Performance of CT of the Extracranial Head and Neck
• ACR Appropriateness Criteria: Neck Mass/Adenopathy
• Radiopaedia: soft tissue neck CT ( link
• ACR Appropriateness Criteria: Neck Mass/Adenopathy
• Radiopaedia: soft tissue neck CT ( link
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.