Imaging for Sublingual Abscess

Primary Imaging Recommendation

The American College of Radiology notes that CT with IV contrast has superior accuracy (85-95% sensitivity and specificity) for detecting and characterizing abscesses compared to ultrasound or clinical examination alone, with IV contrast enhancement helping distinguish abscess walls from surrounding edematous tissue and identifying complications 1, 2, 3, 4

MRI without and with IV contrast is an excellent alternative if CT is contraindicated or for complex cases requiring detailed soft tissue characterization, providing superior spatial and contrast resolution for soft tissue infections, excellent definition of anatomical relationships for surgical planning, and avoidance of radiation exposure 2, 5
The American College of Radiology recommends against using ultrasound for sublingual abscess evaluation due to its limited ability to visualize deep tongue structures, operator-dependent technique, and difficulty in achieving adequate probe contact due to tongue pain and swelling 3, 5