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Background: The purpose of this study was to assess the influence of head and neck pathologies on the detection rate, configuration and diameter of the thoracic duct (TD) and right lymphatic duct (RLD) in computed tomography (CT) of the head and neck., Methods: One hundred ninety-seven patients were divided into the subgroups "healthy", "benign disease" and "malignant disease". The interpretation of the images was performed at a slice thickness of 3 mm in the axial and coronal plane. In each case we looked for the distal part of the TD and RLD respectively and subsequently evaluated their configuration (tubular, sacciform, dendritic) as well as their maximum diameter and correlated the results with age, gender and diagnosis group., Results: The detection rate in the study population was 81.2 % for the TD and 64.2 % for the RLD and did not differ significantly in any of the subgroups. The predominant configuration was tubular. The configuration distribution did not differ significantly between the diagnosis groups. The mean diameter of the TD was 4.79 ± 2.41 mm and that of the RLD was 3.98 ± 1.96 mm. No significant influence of a diagnosis on the diameter could be determined., Conclusions: There is no significant influence of head/neck pathologies on the CT detection rate, morphology or size of the TD and RLD. However our study emphasizes that both the RLD and the TD are detectable in the majority of routine head and neck CTs and therefore reading physicians and radiologists should be familiar with their various imaging appearances.

Introduction: The aim of the study was to compare the detectability of neck vessels with contrast enhanced magnetic resonance angiography (MRA) in the setting of a whole-body MRA and multislice computed tomography angiography (CTA) for preoperative vascular mapping of head and neck., Methods: In 20 patients MRA was performed prior to microvascular reconstruction of the mandible with osteomyocutaneous flaps. CTA of the neck served as the method of reference.1.5 T contrast enhanced magnetic resonance angiograms were acquired to visualize the vascular structures of the neck in the setting of a whole-body MRA examination. 64-slice spiral computed tomography was performed with a dual-phase protocol, using the arterial phase images for 3D CTA reconstruction. Maximum intensity projection was employed to visualize MRA and CTA data. To retrieve differences in the detectability of vessel branches between MRA and CTA, a McNemar test was performed., Results: All angiograms were of diagnostic quality. There were no statistically significant differences between MRA and CTA for the detection of branches of the external carotid artery that are relevant host vessels for microsurgery (p = 0.118). CTA was superior to MRA if all the external carotid artery branches were included (p < 0.001)., Conclusions: MRA is a reliable alternative to CTA in vascular mapping of the cervical vasculature for planning of microvascular reconstruction of the mandible. In the setting of whole-body MRA it could serve as a radiation free one-stop-shop tool for preoperative assessment of the arterial system, potentially covering both, the donor and host site in one single examination.

Objectives: Aim of the study was to evaluate if a whole-body magnetic resonance angiography (MRA) protocol meets the requirements to evaluate the donor and host site target vessels for planning of microvascular head and neck reconstructions., Patients and Methods: In 20 patients, scheduled for reconstruction of the mandible with fibular free flaps, contrast-enhanced whole-body MRA was performed prior to surgery. 32-Channel 1.5-T MR angiograms were acquired using a 2-step contrast (gadobutrol) injection scheme to visualize the arterial vasculature from head to feet. Maximum intensity projection and multiplanar reconstruction technique was employed to visualize MRA data. For image evaluation the arterial tree was divided into 51 segments. The presence of artefacts impairing diagnostic quality was noted. Evaluable segments were assessed regarding the presence of stenoses >50% diameter reduction, occlusions or aneurysms., Results: No adverse reactions or complications occurred. Of 1020 vessel segments 1003 (98.3%) were evaluable. 36 stenoses >50%, 50 occlusions and one aneurysm were observed. In 21 of 40 lower limbs relevant atherosclerotic changes were depicted., Conclusion: Whole-body MRA proved to be a suitable three-dimensional, noninvasive, nonionising modality for preoperative evaluation of the entire arterial vasculature., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)