Title:Ultrasound Imaging of Cervical Anatomic Variants
Volume: 17
Author(s): Michael Cordes*, Stephan Coerper, Torsten Kuwert and Christian Schmidkonz
Affiliation:
- Nuklearmedizinische Klinik, Universitätsklinikum Erlangen,Germany
Keywords:
Cervical anomalies, cervical cysts, thyroid anomalies, parathyroid gland anomalies, cervical ultrasound, zuckerkandl
tubercles (ZTs).
Abstract: Embryologic developmental variants of the thyroid and parathyroid glands may cause
cervical anomalies that are detectable in ultrasound examinations of the neck. For some of these developmental
variants, molecular genetic factors have been identified. Ultrasound, as the first-line
imaging procedure, has proven useful in detecting clinically relevant anatomic variants. The aim of
this article was to systematically summarize the ultrasound characteristics of developmental
variants of the thyroid and parathyroid glands as well as ectopic thymus and neck cysts. Quantitative
measures were developed based on our findings and the respective literature. Developmental
anomalies frequently manifest as cysts that can be detected by cervical ultrasound examinations.
Median neck cysts are the most common congenital cervical cystic lesions, with a reported prevalence
of 7% in the general population. Besides cystic malformations, developmental anomalies
may appear as ectopic or dystopic tissue. Ectopic thyroid tissue is observed in the midline of the
neck in most patients and has a prevalence of 1/100,000 to 1/300,000. Lingual thyroid accounts for
90% of cases of ectopic thyroid tissue. Zuckerkandl tubercles (ZTs) have been detected in 55% of
all thyroid lobes. Prominent ZTs are frequently observed in thyroid lobes affected by autoimmune
thyroiditis compared with normal lobes or nodular lobes (P = 0.006). The correct interpretation of
the ultrasound characteristics of these variants is essential to establish the clinical diagnosis. In the
preoperative assessment, the identification of these cervical anomalies via ultrasound examination
is indispensable.