MADELUNG-DISEASE - DISTRIBUTION OF CERVICAL FAT AND PREOPERATIVE FINDINGS AT SONOGRAPHY, MR, AND CT

PURPOSE: Our goal was to document the distribution of excess fat in th e neck and to determine the preoperative role of sonography, CT, and M R imaging in patients with Madelung disease. METHODS: Eight patients w ith Madelung disease were examined preoperatively with sonography, CT, and MR imaging of the neck, and the extent to which each technique pr ovided answers to the surgeons' questions-such as distribution of fat, course of the major vessels within the fat, and presence of tracheal compression and nonlipomatous lesions-was studied. RESULTS: Excess fat was seen predominantly in the posterior part of the neck (eight patie nts), under the trapezius (eight patients) and sternomastoid (six pati ents) muscles, in the supraclavicular fossa (five patients), between t he paraspinal muscles (five patients), in the anterior part of the nec k (suprahyoid in seven patients and infrahyoid in three patients), in the superior mediastinum (three patients), and in the prevertebral spa ce (two patients). Excess fat deposition was also seen in the pretrach eal space tone patient), extrapleural space (two patients), and over t he cheeks tone patient), sites previously not described. CONCLUSION: A s a preoperative investigative tool for Madelung disease, both MR imag ing and noncontrast CT provide the surgeon with adequate information; sonography is less helpful.