Paediatric neck ultrasonography: a pictorial essay

  • Maria Grazia Caprio
  • Marco Di SerafinoEmail author
  • Giuseppe Pontillo
  • Norberto Vezzali
  • Eugenio Rossi
  • Francesco Esposito
  • Massimo Zeccolini
  • Gianfranco Vallone
Pictorial Essay


The neck structures are located very superficially and are therefore easy to explore by ultrasound examination. Ultrasonography is crucial for the detection of neck pathologies in children. High-frequency probes (10–15 MHz) are used for the ultrasound examination on the patient lying in supine decubitus and with their neck stretched out. The outcome of the exam depends mainly on the child’s cooperation—hence the need for warm sonographic gel and a comfortable cushion to place under the patient’s shoulders. The complete scan of the neck includes the evaluation of the thyroid and salivary glands and the vascular structures as well as the lymph node analysis. In children and adolescents, the thymus is often visualised in the supraclavicular and jugular scans. It appears as a structure, usually hypoechoic, with thin hyperechoic straps, though echogenicity increases with age. In this pictorial essay, the main pathological conditions of the neck in paediatric age will be examined, such as thyroid dysgenesis, thyroiditis, thyroid nodules, lymphadenopathies, cystic lesions, haemangiomas and vascular malformation, cervical thymus, fibromatosis colli and pilomatrixoma.


Ultrasound examination Neck structures Paediatric age High-frequency probes 


Le strutture del collo sono localizzate molto superficialmente, quindi facili da esplorare con l’esame ecografico. L’ecografia è fondamentale per la rilevazione delle patologie del collo nei bambini. Per l’esame ecografico vengono utilizzate sonde ad alta frequenza (10–15 MHz) con il paziente in decubito supino e con il collo iperesteso. L’esito dell’esame dipende principalmente dalla cooperazione del bambino - da qui la necessità di un gel ecografico caldo e un comodo cuscino da posizionare sotto le spalle del paziente. La scansione completa del collo comprende la valutazione della tiroide e delle ghiandole salivari, delle strutture vascolari e l’analisi dei linfonodi. Nei bambini e negli adolescenti, il timo è spesso visualizzato nelle scansioni sovraclaveari e giugulari. Appare come una struttura solitamente ipoecogena con sottili strie iperecogene, sebbene l’ecogenicità aumenti con l’età. In questo saggio pittorico verranno esaminate le principali condizioni patologiche del collo in età pediatrica, quali disgenesia tiroidea, tiroidite, noduli tiroidei, linfoadenopatie, lesioni cistiche, emangiomi e malformazioni vascolari, timo cervicale, fibromatosis colli e pilomatrixoma.


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and its later amendments.

Human and animal rights

This article does not contain any studies with human or animal subjects performed by any of the authors.

Informed consent

Additional informed consent was obtained from all the patients for which identifying information is not included in this article.


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Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2018

Authors and Affiliations

  1. 1.Paediatric Radiology Department“Federico II” University HospitalNaplesItaly
  2. 2.Radiology Department“Antonio Cardarelli” HospitalNaplesItaly
  3. 3.Radiology DepartmentRegional Hospital of BolzanoBolzanoItaly
  4. 4.Radiology Department“Santobono-Pausilipon” Children HospitalNaplesItaly

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