Abstract: Objective To analyze the clinical and imaging features of the children patients with abscess and non-abscess cervical infectious masses, and compare the differences of diagnosis, treatment and prognosis between the two groups. Method A total of 71 cases of neck infection in children in the Women and Children's Medical Center of Guangzhou Medical University from January 2016 to August 2023 were collected, and they were divided into abscess group (49 cases) and non-abscess group (22 cases) according to the presence or absence of abscess formation.The clinical and imaging characteristics, therapeutic methods and prognosis effects between the two groups were analyzed. Result Among the children with abscess, 31 had fever and 42 had elevated C-reactive protein（CRP）. In 49 cases, the masses were palpable, the texture of the masses was soft in 21 cases, the mobility of the masses was poor in 41 cases, the skin temperature was increased in 18 cases, and the boundaries were blurred in 36 cases. 10 cases involved three or more neck spaces. Among the children with non-abscess, 6 had fever and 9 had elevated CRP. There were palpable neck masses in 19 cases, tough masses in 10 cases, poor mobility in 16 cases, increased skin temperature in 5 cases, and blurred borders in 8 cases. 10 cases involved three or more neck spaces. There were statistically significant differences in clinical manifestations, laboratory parameters and imaging features between the abscess group and the non-abscess group in terms of whether the mass was palpable (P=0.008), the texture of the mass (P=0.027), the activity (P=0.031), the skin temperature (P=0.022), the CRP level(P<0.001), and the lesion boundary(P=0.003). The common causes of neck infection in children patients are piriform fossa fistula, lymphadenitis, and lymphatic malformations. The results of surgical treatment showed that the incidence of postoperative complications was lower in the abscess group (4.1%) and non-abscess group (9.1%). Conclusion Children with abscess neck infection differed significantly from those non-abscess types in terms of clinical and imaging features, and contrast-enhanced, CT or MRI provides an important reference for the diagnosis, differential diagnosis and selection of clinical treatment methods for neck infection.

Key words: Infectious neck mass, Abscess, Clinical presentation, Image feature, Children