E5541. Neck Ultrasound: Definitive Guide to Anatomy - Normal and Abnormal
  1. Carla Harmath; University of Chicago
  2. Camila Lopes Vendrami; Northwestern University
  3. Senta Berggruen; Northwestern University
  4. Nancy Hammond; Northwestern University
  5. Nisa Oren; University of Chicago
  6. Grace Lee; University of Chicago
  7. Helena Gabriel; Northwestern University
The lymph nodes in the neck have been divided into seven anatomic levels for cancer staging and therapy planning by the simplified classification advocated by Shah et al. There are differing definitions across the specialties, and minor variations to these anatomic boundaries have also been described. These nodal stations remain a source of confusion and uncertainty to radiologists. The purpose of this exhibit is to provide a detailed, comprehensive depiction of neck anatomy and the sonographic landmarks adapted for the location of lesions, according to the nodal levels I to VII with CT/MR and diagrammatic correlation.

Educational Goals / Teaching Points
The goal of this exhibit is to provide a comprehensive and easily understandable guide to learn neck nodal station anatomy (normal and abnormal) by delineating anatomical landmarks and levels on ultrasound with CT/MR correlation and diagrammatic assistance.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Imaging plays an important role in (I) confirming the N0 status of the neck, (II) documenting lymphadenopathy contralateral to clinically palpable disease, (III) evaluating the regional extent of disease especially in relation to neurovascular structures, and (IV) nodal surveillance for follow-up. Radiologists should be familiar with the anatomical distribution of cervical nodes and their relationship with the simplified level classification system, as well as to correlate the different types of imaging techniques.

Radiologists should be familiar with the anatomical distribution of cervical nodes as well as with the simplified level nodal classification system. Thus, imaging reports should document any lymphadenopathies using a common classification system to facilitate communication.