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Differential Diagnosis in Head and Neck Imaging

Table of Contents


General Part
1 Introduction
Concept and Approach
Systematic Approach to the Analysis of Radiologic Findings in the Head and Neck Region
Clinical Examination Techniques
2 Diagnostic Imaging Techniques
Conventional Radiography
Sectional Imaging Modalities
Computed Tomography
Magnetic Resonance Imaging
Radionuclide Imaging
Diagnostic Angiography and Interventional Treatment
Principles in the Interpretation of Normal Tissue Structures in Imaging Techniques
Interpretation of Normal Tissue Structures in MRI
Muscle Tissue
Fatty Tissue
Cartilage

Special Part
3 Anterior Skull Base
Normal Anatomy
Basal Foramina
Sella turcica
Cavernous Sinus
Clivus
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Ultrasound
Conventional Radiography
Computed Tomography
Magnetic Resonance Imaging
Value of Different MR Sequences
Radionuclide Imaging
Radionuclide Bone Scans
Immunoscintigraphy
CSF Scintigraphy
Imaging Findings
Congenital Variations and Malformations (Figs. 3.3, 3.4a, and Table 3.6)
Tumors (Tables 3.7 and 3.8)
Inflammatory Lesions
Traumatic Lesions
Iatrogenic Lesions
Imaging Criteria and their Differential Diagnosis
Liquid Masses
Air-Containing Masses
Tumor Masses
Osseous Lesions
Expansion of the Bony Structures of the Skull Base
Structural Defects of the Bony Skull Base
Summary and Diagnostic Strategy

4 Middle Skull Base and Middle Ear
Normal Anatomy
Blood Supply and Innervation
Neurovascular Compartments of the Temporal Bone
Carotid Canal
Hypoglossal Canal
Clinical Signs and Symptoms
Clinical Differential Diagnosis of Hearing Disorders
Differential Diagnosis of Lesions Causing Peripheral Facial Nerve Palsy (Bell's Palsy) (Fig. 4.24)
Imaging Evaluation and Differential Diagnosis
Conventional Radiography
Computed Tomography
Magnetic Resonance Imaging
Imaging Findings
Congenital Variations and Malformations
Tumors
External Auditory Canal
Middle Ear
Inflammatory Lesions
Imaging Criteria and Their Differential Diagnosis
Tumor Mass in the External Auditory Canal (Table 4.9)
Increased Pneumatization of the Temporal Bone (Table 4.10)
Liquid Lesions in the Tympanic Cavity and Mastoid (Table 4.11)
Faintly Enhancing Solid Tumor Mass in the Tympanic Cavity (Table 4.12)
Intensely Enhancing (Hypervascular) Solid Tumor Mass in the Tympanic Cavity (Table 4.13)
Erosion or Destruction of the Temporal Bone (Tympanic Cavity, Middle Ear, Mastoid) (Table 4.14)
Osteosclerotic Process of the Temporal Bone (Table 4.15)
Enhancing Facial Nerve Lesion With No Mass Effect (Tables 4.16, 4.17)
Tumor Mass of the Facial Nerve (Table 4.18)
Hypoplasia of the Jugular Foramen
Erosive and Destructive Lesions of the Jugular Foramen (Table 4.19)
Destructive Petrous Apex Lesion (Table 4.20)
Mass Lesion in the Mastoid
Traumatic Lesions of the Temporal Bone
Focal Enhancing Facial Nerve Lesion Showing Remission at Follow-Up
Summary and Diagnostic Strategy

5 Internal Auditory Canal, Cerebellopontine Angle, and Labyrinth
Normal Anatomy
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Conventional Radiography
Computed Tomography
Magnetic Resonance Imaging
Imaging Findings
Congenital Variations and Malformations
Malformations of the Inner Ear
Tumors
Osteodystrophic Diseases of the Temporal Bone (Otosclerosis, Otospongiosis)
Temporal Bone Trauma (Figs. 5.31, 5.32)
Imaging Criteria and Their Differential Diagnosis
Asymmetric Expansion of the Internal Auditory Canal on Conventional Radiography and CT
Solid Enhancing Mass Larger than 5 mm in the Internal Auditory Canal on CT or MRI
Solid Enhancing Mass Smaller than 5 mm in the Internal Auditory Canal (on MRI Only)
Linear Enhancement in the Internal Auditory Canal (on MRI)
Solid Enhancing Mass in the Cerebellopontine Angle on CT or MRI
Cystic Mass in the Cerebellopontine Angle, Internal Auditory Canal, or Inner Ear
Air in the Cerebellopontine Angle and Internal Auditory Canal
Hyperintense Lesion on Unenhanced T1-Weighted Spin-Echo MRI
Enhancing Labyrinthine Structures
Bleeding into the Labyrinth
Absence of MRI Signal in the Labyrinth
Brainstem Mass
Cystic or Necrotic Mass in the Posterior Cranial Fossa
Mass of the Clivus and Prepontine Cistern
Ring Enhancement in the Posterior Cranial Fossa
Multiple Enhancing Masses in the Cerebellum and Bordering Spaces
Bony Erosion of the Petrous Apex
Bony Erosion of the Internal Auditory Canal
Erosion of Bony Structures in the Middle Cranial Fossa
Erosion of the Sphenoid Bone
Masses Associated with Increased Radiographic Density of the Temporal Bone
Mass in the Foramen ovale
Summary and Diagnostic Strategy

6 Nasopharynx and Nasal Cavity
Normal Anatomy
Nasopharynx
Nasal Cavity
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Conventional Radiography
Computed Tomography
Magnetic Resonance Imaging
Imaging Findings
Congenital Variations and Malformations
Tumors
Inflammatory Lesions
Iatrogenic Changes
Imaging Criteria and Their Differential Diagnosis
Liquid Masses
Masses with Moderately High T2-Weighted Signal Intensity
Tumor Masses
Bone Destruction
Abnormal Air Collections in the Nasopharynx
Summary and Diagnostic Strategy

7 Paranasal Sinuses and Adjacent Facial Skeleton
Normal Anatomy
Maxillary Sinus
Ethmoid Sinus
Frontal Sinus
Sphenoid Sinus
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Ultrasound
Conventional Radiography
Computed Tomography
Digital Subtraction Angiography (DSA)
Magnetic Resonance Imaging
Imaging Findings
Congenital Variations and Malformations
Tumors
Benign Tumors
Malignant Tumors
Inflammatory Lesions (Fig. 7.15)
Traumatic Lesions (Figs. 7.4--7.8)
Iatrogenic Changes
Imaging Criteria and Their Differential Diagnosis
Deformity or Asymmetry of the Paranasal Sinuses (Tables 7.6, 7.7)
Liquid Sinus Masses on CT
Sinus Tumor Masses on CT or MRI (Table 7.9)
Radiographically Dense Sinus Lesions (Table 7.10)
Sinus Lesions with High T2-Weighted Signal Intensity
Sinus Lesions with Low T2-Weighted Signal Intensity
Circumscribed Facial Swelling
Bone Destruction
Summary and Diagnostic Strategy

8The Orbit
Normal Anatomy
The Globe
Orbital Nerves
Orbital Vessels
Muscles and Orbital Fat
Lacrimal Gland
Bony Boundaries of the Orbit
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Conventional Radiography
Dacryocystography
Computed Tomography
Magnetic Resonance Imaging
Ultrasound
Diagnostic Angiography and Interventional Procedures
Imaging Findings
Congenital Variations, Malformations, and Congenital Lesions
Tumors
Inflammatory Lesions (Fig. 8.8)
Nonspecific Myositis
Traumatic Lesions
Imaging Criteria and their Differential Diagnosis
Liquid Masses
Air-Containing Masses
Tumor Masses (Figs. 8.4--8.6)
Osseous Lesions (Fig. 8.12)
Summary and Diagnostic Strategy

9 Parapharyngeal Space and Adjacent Deep Compartments
Normal Anatomy
Masticator Space
Infratemporal Fossa
Buccal Space
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Imaging Findings
Congenital Variations and Malformations
Tumors
Inflammatory Lesions
Vascular Lesions of the Parapharyngeal Space and Bordering Spaces
Traumatic Lesions
Iatrogenic Lesions
Imaging Criteria and their Differential Diagnosis
Liquid Masses (Table 9.2)
Air-Containing Masses
Tumor Masses of the Prestyloid Compartment
Tumor Masses of the Poststyloid (Retrostyloid) Compartment
Tumor Masses of the Masticator Space
Summary and Diagnostic Strategy

10 Salivary Glands
Normal Anatomy (Fig. 10.1)
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Sialography
Magnetic Resonance Imaging
Computed Tomography
Imaging Findings
Congenital Variations and Malformations
Cystic Lesions
Benign Salivary Gland Tumors
Malignant Salivary Gland Tumors
Inflammatory Lesions
Systemic and Degenerative Lesions
Iatrogenic and Posttherapeutic Lesions
Imaging Criteria and their Differential Diagnosis
Cystic Masses (Fig. 10.2)
Tumor Masses of the Parotid Gland
Tumor Masses of the Sublingual and Submandibular Glands
Reticular Parenchymal Changes
Summary and Diagnostic Strategy

11 Temporomandibular Joint
Normal Anatomy
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Conventional Radiography
Invasive Arthrography
Computed Tomography
Magnetic Resonance Imaging
Assessment of Mandibular Opening
Contrast Agents
Imaging Findings
Congenital Variations and Malformations
Tumors
Benign Tumors
Benign Nonodontogenic Tumors
Histiocytosis X
Malignant Tumors
Arthritis
Degenerative Diseases
Joint Trauma
Disk Displacement
Imaging Criteria and their Differential Diagnosis
Disk Displacement
Shape and Structural Changes in the Articular Disk
Differential Diagnosis of Internal Derangement
Altered Signal Intensity of the Mandibular Condyle on MRI
Effusion and Soft-Tissue Proliferation in the TMJ (Tables 11.13--11.15)
Mass Lesions
Condylar Hyperplasia
Expansion of the Mandibular Condyle and Articular Structures
Summary and Diagnostic Strategy

12 Oral Cavity, Oropharynx, and Oral Floor
Normal Anatomy
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Conventional Radiography
Ultrasound
Computed Tomography
Digital Subtraction Angiography
Radionuclide Imaging
Magnetic Resonance Imaging
Imaging Findings
Congenital Variations and Malformations
Tumors
Inflammatory Lesions
Traumatic Lesions
Iatrogenic Changes
Staging of Nodal Disease
Imaging Criteria and their Differential Diagnosis
Liquid Masses or Lesions of the Oropharynx and Oral Cavity
Air-Containing Masses or Lesions of the Oropharynx and Oral Cavity
Tumor Masses
Benign Tumors
Inflammatory Lesions of the Oropharynx and Oral Cavity
Bone Destruction
Summary and Diagnostic Strategy

13 Hypopharynx and Larynx
Normal Anatomy
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Computed Tomography
Magnetic Resonance Imaging
Imaging Findings
Congenital Variations and Malformations
Tumors
Benign Tumors
Malignant Tumors
Semimalignant Tumors
Inflammatory Lesions
Degenerative Changes
Traumatic Lesions
Iatrogenic and Posttherapeutic Changes
Imaging Criteria and their Differential Diagnosis
Liquid Masses
Air-Containing Masses
Solid Tumor Masses
Laryngeal Cartilage Destruction
Unilateral Vocal Cord Paralysis
Summary and Diagnostic Strategy

14 Soft Tissues of the Neck
Normal Anatomy
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Imaging Findings
Congenital Variations and Malformations
Tumors
Inflammatory Lesions
Vascular Lesions
Traumatic Lesions
Iatrogenic and Posttherapeutic Changes
Imaging Criteria and their Differential Diagnosis
Liquid Masses
Air-Containing Masses and Structures
Solid Tumor Masses
Thyroid Abnormalities
Vascular Lesions
Summary and Diagnostic Strategy

15 Prevertebral Space Including the Trachea and Esophagus
Normal Anatomy
Clinical Signs and Symptoms
Imaging Evaluation and Differential Diagnosis
Conventional Oral Contrast Examination
Conventional Radiography
Computed Tomography
Magnetic Resonance Imaging
Ultrasound
Imaging Findings
Congenital Variations and Malformations
Tumors
Inflammatory Lesions
Degenerative and Systemic Diseases
Vascular Lesions
Traumatic Lesions
Iatrogenic and Posttherapeutic Changes
Imaging Criteria and their Differential Diagnosis
Expansion of the Retropharyngeal or Prevertebral Space
Tumor Masses Related to Bone
Tumor Masses of the Trachea
Liquid or Air-Filled Masses of the Esophagus
Primary Dilatation of the Esophagus
Esophageal Stenosis with or without Prestenotic Dilatation
Changes in the Esophageal Mucosa
Cartilage Changes
Tracheal Stenosis
Summary and Diagnostic Strategy

 
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