What is the preferred imaging method used to assess neck lymph nodes?

Hello doctor,

I have asked you a question in the past, and you were kind and thorough. So here is another question; it is a general one. If any of these tests were done, would they show the lymph nodes of the neck? Perhaps as an incidental finding?

1. MRI (magnetic resonance imaging) of the brain.
2. MRI of the cervical spine.
3. CT (computed tomography) of the cervical spine.
4. MRA (magnetic resonance angiography) of the head.
5. MRA with contrast of the neck.
6. CT of the sinuses.
7. Cone-beam CT of the head and neck (dental).

I tried to ask a radiologist, but my answer was from an internist. I do not think he understood my question.

Please help me.

Thank you

Hello doctor,

Thank you for the reply.

I have had all the above-mentioned tests for another issue. I have a small inflamed tonsillar lymph node, which has been that way for a very long time. I just wondered if any of the tests I mentioned would have visualized the node because they focused on the brain and cervical spine, not the neck (soft tissue). The only specific neck and not cervical spine was the MRI (magnetic resonance imaging) with contrast, which would have visualized the arteries. No nodes were mentioned in any of the tests.

Would it have been an incidental finding?

Please help.

Thank you.

Hi doctor,

Thank you for you reply.

I have had severe facial and back-of-head pain at times. I also experience facial flushing. For several years, I have had a palpable small node in my neck and always wondered about it. I have also had an elevated sedimentation rate, which they said was meaningless. I had previously written to you about my elevated ALP, which persisted, so they sent me to a liver specialist. They concluded that I have an elevated ALP (alkaline phosphatase) because I fall outside of normal guidelines. Initially, they thought my face or head pain was due to a sinus infection, then considered trigeminal neuralgia (severe facial pain), dystonia (neurological movement disorder), cluster headaches, Eagle syndrome (pain in the neck and throat), and now occipital neuralgia (pain in the head, neck, and behind the ears). My cervical spine is a mess, but given my age, I feel like it comes from my neck, though they do not agree.

I get Botox for my face and lidocaine for my occipital area. I am not sure if it really helps, but I have learned to live with it. I also have a persistently curious, very low A1C with normal blood sugars. One doctor finds it curious; another says it is meaningless. I think it is from iron supplements. I am a vegan, and I thought maybe I was deficient in nutrients, so I increased my plant protein and others. So, I was just wondering about the MRI (magnetic resonance imaging), CT (computed tomography), or MRA (magnetic resonance angiography). I thought an MRI or CT of the cervical spine was different from a neck MRI or CT, so it is good to know it is the same. I also thought it would show up on the brain MRI as it is not far from my ear. I tried phoning the radiologist, but they do not take patient calls.

Please help.

Thank you.