颈部囊性肿块的超声诊断与鉴别诊断

目的探讨超声对颈部囊性肿块的定位定性诊断能力.方法回顾分析经手术及病理证实的颈部囊性病变57例.结果常见鳃裂囊肿表现为无回声区,内有点状强回声.它们位于腮腺下方下颌角区胸锁乳突肌上1/3前缘,颈动静脉位于其深面偏内.甲状舌骨囊肿表现为边界清晰的无回声区,位于舌骨周围的中线区.神经鞘瘤及淋巴结囊性变表现为大部分囊性,且边界清晰的无回声,仅内部小区有絮状中等回声.肿块均位于前斜角肌前方.血管瘤均显示为边界清晰并有后方回声增强的无回声.甲状腺、涎腺、甲状旁腺囊肿表现为包膜清晰的无回声区,位于甲状腺或涎腺内,甲状旁腺囊肿一般位于甲状腺后方.表皮囊肿表现位与皮肤关系密切的无回声.结论结合超声声像图表现和肿块的位置及与周围组织结构的关系,可以较准确地评估颈部囊性肿块的性质.

Diagnosis and differential diagnosis of neck cystic masses by ultrasonography

Objective The study on ultrasonography in locating and determining the neck cystic masses.Methods A retrospective review of 57 patients with neck masses identified with surgical and pathological diagnosis was performed. Results Most branchial cleft cysts appeared as anechoic area with spotted strong signals. They were located at the submaxillary area, under the parotid, upper one third of front line of the sternomastoid muscle and carotids located in branchial cleft. Thyroglossal duct cysts were well marginated anechoic areas. They were located toward the midline, close to the hyoid. Neurofibromas or lymph cysts presented mostly as cystic, well defined anechoic lesions with flocculent medium level echoes. They were located ahead of scaleus anterior muscle. All the aneurysms were well marginated anechoic, with posterior enhancement. Thyroid, parathyroid, salivary gland cysts were well defined anechoic. Parathyroid cysts were always attached to the thyroids posteriorly. Epidermal cysts were anechoic and skin related. Conclusion Upon imaging them and their vicinity by ultrasonography, neck cystic masses can be characterized more accurately.