CT Neck (Non-Contrast)

Last updated January 25, 2026

Altered images of CT non-contrast neck scan

Similar expressions

CT Neck/ NCCT neck/ non-contrast neck

Introduction

CT Neck scan is used for the assessment of congenital abnormalities, foreign body, neoplasms, trauma and palpable masses. In usual practice, non-contrast neck step is combined with contrast steps such as 4D neck and neck-contrast for complex diagnosis.

Patient preparation

  • Explain the procedure kindly and clearly.
  • Remove metal related to the neck area (necklaces, undergarments).
  • Ask to be steady and not to swallow during the procedure.
  • Inform to breath slowly during the procedure.

Patient positioning

  • Position in head-first and supine position.
  • Center the scanning area in the scanner iso-center [5].

Explanation: this reduces overall radiation exposure and increases image quality.

  • Extend the neck slightly.

Explanation: reduces streak artifacts or beam hardening artifacts due to the lower jaw. Same results can be achieved by angulating CT gantry.

  • Position the shoulders in a pulled down position and arms next to the body.

Explanation: reduces streak artifacts or beam hardening artifacts due to wide shoulders. Placing a cushion under mid-upper thorax moves shoulders posteriorly, and helps to reduce streak artifacts at the root of the neck [2].

  • Plan the scout starting point at the level of clavicles.

Scan planning

  • Plan the scan slab to cover from the skull base to the top of the aortic-arch.
Demonstrates scan slab planning for routine NCCT neck.
  • For studies to assess vocal cord palsy, the inferior extent of the scan area should extend to  aortopulmonary window or carina.
Demonstrates scan slab planning for CT non-contrast neck scan. Inferior point is extended to aortopulmonary window if the diagnosis is vocal cord palsy.

Post-processing

  • Axial, coronal and sagittal images in soft-tissue window (WW: 400, WL:40), without exceeding 3mm slice thickness – reach our Neck contrast article for images.
  • Additionally, a suitable image in bone (WW: 3500, WL:350) window, displayed in any plane, without exceeding 3mm slice thickness.
  • For vocal cord neoplasms, 1mm thin sections of multi planer reformats (MPR) are helpful insoft-tissue window limited to the larynx, and axial slices are reformatted parrel to the vocal cords or hyoid bone.
Demonstrates multiplanar reconstruction (MPR) for vocal cord neoplasms of a NCCT neck scan.

Reference

  1. Ashley H. Aiken, MD, Chair, Paul M. Bunch, MD, & Kavita K. Erickson, MD. (2021). ACR–ASNR–SPR Practice parameter for the performance of computed tomography (CT) of the extracranial head and neck.Retrieved from www.gravitas.acr.org.
  2. Harvey, G. D., Mayer, D. P., & Radecki, P. D. (1984). Simplified patient positioning to reduce beam hardening in CT of the lower neck. AJNR. American journal of neuroradiology, 5(6), 796.
  3. Chin SC, Edelstein S, Chen CY, Som PM. Using CT to localize side and level of vocal cord paralysis.AJR Am J Roentgenol. 2003 Apr;180(4):1165-70. doi: 10.2214/ajr.180.4.1801165. PMID: 12646476.
  4. Becker M, Leuchter I, Platon A, Becker CD, Dulguerov P, Varoquaux A. Imaging of laryngeal trauma.Eur J Radiol. 2014 Jan;83(1):142-54. doi: 10.1016/j.ejrad.2013.10.021. Epub 2013 Oct 27. PMID: 24238937.
  5. Romanyukha, A., Nzitunga, P. S., & Dolcet, A. (2022, April 28). CT patient positioning plays key role in radiation dose reduction.www.auntminnie.com.
  6. Bashir MH, Joyce C, Bolduan A, Sehgal V, Smith M, Charous SJ. Revisiting CT Signs of Unilateral Vocal Fold Paralysis: A Single, Blinded Study. AJNR Am J Neuroradiol. 2022 Apr;43(4):592-596. doi: 10.3174/ajnr.A7451. Epub 2022 Mar 24. PMID: 35332018; PMCID: PMC8993190.