There is excessive enhancement or thickening of the mucosa or hypertrophy of the lymphoid tissue in the nasopharynx.   [Yes/No]

There is evidence of an abscess within the lymphoid tissue of the nasopharynx.   [Yes/No]

There is edema within the fat of the adjacent parapharyngeal space.   [Yes/No]

There is abscess within the fat of the adjacent parapharyngeal space.   [Yes/No]

There is edema within the fat of the adjacent retropharyngeal space.   [Yes/No]

There is an abscess within the fat of the adjacent retropharyngeal space.   [Yes/No]

There is excessive enhancement or thickening of the mucosa or hypertrophy of the palatine or lingual tonsillar tissue or the lymphoid tissue along the glossotonsillar sulci and posterior pharyngeal wall.   [Yes/No]

There is abscess relatively centrally within the lymphoid tissue of the palatine tonsil.   [Yes/No]

There is abscess at the periphery of the lymphoid tissue of the palatine tonsil within the potential peritonsillar space.   [Yes/No]

There is edema within the fat of the adjacent parapharyngeal space.   [Yes/No]

There is abscess within the fat of the adjacent parapharyngeal space.   [Yes/No]

There is edema within the fat of the adjacent retropharyngeal space.   [Yes/No]

There is an abscess within the fat of the adjacent retropharyngeal space.   [Yes/No]

There is reactive retropharyngeal lymphadenopathy.   [Yes/No]

There is suppurative retropharyngeal lymphadenopathy.   [Yes/No]

If there is suppurative retropharyngeal adenopathy what is the maximum short axis dimension of the largest suppurative node. MEASUREMENT   [Yes/No]

There is related edema/abscess within the adjacent parapharyngeal/retropharyngeal spaces.   [Yes/No]

There is significant abnormality of these structures that would be an alternate explanation for the patient’s symptoms.   [Yes/No]

There is significant abnormality of the parotid, submandibular or sublingual glands that would be an alternate explanation for the patient’s symptoms.   [Yes/No]

There is excessive enhancement or thickening of the mucosa within the hypopharynx, larynx or trachea.   [Yes/No]

There is edema within the hypopharynx, larynx or trachea.   [Yes/No]

There is abscess within the hypopharynx, larynx or trachea.   [Yes/No]

There is edema within the adjacent deep neck, retropharyngeal and/or prevertebral spaces.   [Yes/No]

There is abscess within the adjacent deep neck, retropharyngeal and/or prevertebral spaces.   [Yes/No]

There is reactive cervical lymphadenopathy.   [Yes/No]

There is suppurative cervical lymphadenopathy.   [Yes/No]

If there is suppurative cervical adenopathy the purulent material outside the lymph node(s) capsule(s).   [Yes/No]

There is evidence of thrombus, thrombophlebitis or other occlusive or inflammatory process of the jugular vein.   [Yes/No]

There is evidence of thrombus, thrombophlebitis or other occlusive or inflammatory process of smaller jugular venous tributaries.   [Yes/No]

There is evidence of thrombus, inflammation of the common, external or internal carotid artery.   [Yes/No]

There is evidence of a contained leakage from an arterial or venous source.   [Yes/No]

There is evidence of active extravasation from an arterial or venous source.   [Yes/No]

The upper lung zones and mediastinum visualized are abnormal.   [Yes/No]

Other significant abnormal findings are present   [Yes/No]