๐ฆท CT SCAN NECK & ORAL CAVITY – STEP BY STEP
1️⃣ WHAT IS CT NECK / ORAL CAVITY?
CT Neck is a scan used to evaluate:
- Oral cavity (tongue, buccal mucosa, palate)
- Pharynx & larynx
- Salivary glands
- Lymph nodes
- Thyroid & soft tissues
๐ Best for tumor, infection & lymph node assessment
2️⃣ WHY DO CT NECK SCAN?
๐ Indications:
- Oral cancer (tongue, buccal mucosa) ๐ฆท
- Neck swelling / lymphadenopathy
- Abscess / infection
- Trauma
- Salivary gland pathology
- Thyroid mass
- Airway obstruction
- Staging & follow-up of malignancy
๐ Contrast CT is most commonly used
3️⃣ PATIENT PREPARATION
- Explain procedure
-
Remove:
- Dentures
- Metal chains
- Hair pins
-
Check history:
- Surgery / cancer
-
For contrast:
- Creatinine level
- Allergy history
๐ Ask patient not to swallow during scan (important)
4️⃣ PATIENT POSITIONING
๐️ Standard:
- Supine position
- Head first
- Neck slightly extended
๐ฏ Alignment:
- Midline centered
- Chin slightly up
- Avoid tilt / rotation
๐ Immobilization important (avoid motion artifacts)
5️⃣ SCAN PLANNING
๐ Coverage:
- From skull base → thoracic inlet
๐ Planning line:
- Axial slices parallel to hard palate
๐ Include:
- Oral cavity
- Oropharynx
- Larynx
- Thyroid
6️⃣ SCAN PARAMETERS (Typical)
- kVp → 120
- mAs → 200–300
-
Slice thickness:
- 3–5 mm (routine)
- 1 mm (thin slices / tumor staging)
- Pitch → ~0.8–1
- Rotation time → 0.5–1 sec
7️⃣ CONTRAST PROTOCOL ๐
- IV non-ionic contrast
- Dose: ~1–1.5 ml/kg
⏱️ Timing:
- Scan delay: 60–70 sec (venous phase)
๐ Important for:
- Tumor enhancement
- Lymph nodes
- Abscess detection
8️⃣ IMAGE RECONSTRUCTION
- Axial images (main)
- Coronal & sagittal (MPR)
- Soft tissue + bone algorithm
9️⃣ FILMING / DISPLAY
๐งพ Routine:
- Axial soft tissue window
- Axial bone window
- Coronal & sagittal views
๐ฏ Window settings:
- Soft tissue → for mass / nodes
- Bone → for mandible / skull base
๐ Always label properly (R/L marker)
๐ COMMON PATHOLOGY
๐ฆท 1. Oral Cancer
- Irregular mass
- Enhancement after contrast
- Invasion to adjacent structures
๐ฆท 2. Lymphadenopathy
- Enlarged nodes
- Necrosis (central hypodensity)
๐ฆท 3. Abscess
- Fluid collection
- Peripheral rim enhancement
๐ฆท 4. Salivary Gland Disease
- Parotid / submandibular swelling
- Stones (hyperdense)
๐ฆท 5. Thyroid Lesion
- Enlargement / nodules
๐ฆท 6. Trauma
- Mandible fracture
- Soft tissue swelling
1️⃣1️⃣ FINDINGS (HOW TO CHECK)
๐ Follow systematic approach:
-
Oral cavity
- Tongue, floor of mouth
-
Pharynx & larynx
- Airway patency
-
Lymph nodes
- Size / necrosis
-
Salivary glands
- Normal / enlarged
-
Thyroid
- Normal / nodular
-
Bone
- Mandible / skull base





