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 the neck and to determine the preoperative role of sonography, CT, and MR imaging in patients with Madelung disease.

METHODS Eight patients with Madelung disease were examined preoperatively with sonography, CT, and MR imaging of the neck, and the extent to which each technique provided 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 patients), under the trapezius (eight patients) and sternomastoid (six patients) muscles, in the supraclavicular fossa (five patients), between the paraspinal muscles (five patients), in the anterior part of the neck (suprahyoid in seven patients and infrahyoid in three patients), in the superior mediastinum (three patients), and in the prevertebral space (two patients). Excess fat deposition was also seen in the pretracheal space (one patient), extrapleural space (two patients), and over the cheeks (one patient), sites previously not described.

CONCLUSION As a preoperative investigative tool for Madelung disease, both MR imaging and noncontrast CT provide the surgeon with adequate information; sonography is less helpful.