Table of Contents
Advances in Otolaryngology
Volume 2014 (2014), Article ID 896831, 8 pages
http://dx.doi.org/10.1155/2014/896831
Research Article

Predicting Neck Abscess with Contrast-Enhanced Computed Tomography

1Department of Diagnostic Imaging, National Cancer Institute, No. 4, Jalan P7, Presint 7, 62250 Putrajaya, Malaysia
2Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
3Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia

Received 1 August 2014; Accepted 20 October 2014; Published 18 November 2014

Academic Editor: Giuseppe Mercante

Copyright © 2014 Melisa Lim Seer Yee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Neck abscesses are difficult to diagnose and treat. Currently, contrast-enhanced computed tomography (CECT) is the imaging modality of choice. The study aims to determine the predictive value of CECT findings in diagnosing neck abscess, causes of neck abscess and the most common neck space involved in the local population. 84 consecutive patients clinically suspected to have neck abscess who underwent CECT and surgical confirmation of pus were included. Demographic and clinical data were recorded. 75 patients were diagnosed as having neck abscess on CECT; out of those 71 patients were found to have pus. Overall CECT findings were found to have a high sensitivity (98.6%) and positive predictive value (PPV) (94.7%) but lower specificity (67.2%) in diagnosing neck abscess. The CECT diagnostic criterion with the highest PPV is the presence of rim irregularity (96%). The most common deep neck space involved is the submandibular compartment, which correlates with the finding that odontogenic cause was the most common identifiable cause of abscess in the study population. Thus, in a patient clinically suspected of having neck abscess, CECT findings of a hypodense mass with rim irregularity are helpful in confirming the diagnosis and guiding clinical management.