The CT and MR imaging features of carcinoma arising in thyroglossal duct remnants

BACKGROUND AND PURPOSE: Carcinoma arising in thyroglossal duct remnants is a well-described entity in the pathology and surgery literature, but it has little recognition in the radiology literature. Preoperative diagnosis may alter surgical management, although this diagnosis is rarely made. This study was undertaken to determine the radiologic features that might differentiate carcinoma from benign thyroglossal duct cysts. METHODS: Twenty-one cases of nonpediatric thyroglossal duct anomalies imaged at our institution during a 15-year period were reviewed retrospectively. The images were assessed for lesion wall thickness, enhancement, soft-tissue component, calcification, and loculation of the cystic component. Three additional cases of thyroglossal duct carcinoma obtained from outside institutions were reviewed for these features also. RESULTS: Six cases of thyroglossal duct carcinoma were reviewed. All cases of carcinoma had solid soft-tissue elements visible on CT scans or MR images, compared with three of 18 cases of benign thyroglossal duct cysts. The malignant component was seen as a small peripherally based mass in relation to a cyst, a solid mass in the expected course of the thyroglossal duct, or a complex invasive mass also in the midline of the neck. CT only revealed calcification in cases of carcinoma, within either the primary carcinoma mass or a metastatic node. CONCLUSION: Thyroglossal duct carcinoma should be suspected in an adult patient in the presence of a solid nodule or invasive features in association with a thyroglossal duct lesion visible on CT scans or MR images. The presence of calcification, which is seen best on CT scans, may be a specific marker for carcinoma.     

甲状舌管囊肿的CT诊断(附15例分析)

目的：探讨甲状舌管囊肿的CT表现及其与发病机制、病理基础的关系。方法：分析15例经手术和病理证实的甲状舌管囊肿的CT表现。结果：15例中。9例表现为颈前正中的圆形、卵圆形或不规则形囊肿，6例偏向一侧。囊肿表现为低密度者12例，等密度者3例。8例囊壁光滑，7例囊壁毛糙，10例发现囊壁内结节影。结论：甲状舌管囊肿的特征性CT表现与其发病机制、病理基础相关。     

甲状舌管囊肿的CT诊断

目的探讨甲状舌管囊肿的CT表现。资料与方法回顾性分析24例CT诊断为甲状舌管囊肿的CT表现。结果 2例表皮样囊肿误诊为甲状舌管囊肿,22例经手术病理证实为甲状舌管囊肿(诊断符合率92%),其中单纯性病变19例,3例继发感染。偏左侧5例、偏右侧4例、位于中线13例。CT表现为颈前三角区囊性肿块,与舌骨、甲状腺关系密切;单纯性病变边缘光整,密度均匀,其中表现为低密度14例,表现为等密度5例,增强扫描囊壁强化,囊内容物不强化;继发感染者囊壁增厚毛糙,增强扫描囊壁强化,囊内容物轻度强化。结论根据甲状舌管囊肿的特定部位及典型CT表现,CT扫描可准确诊断甲状舌管囊肿。     

Diagnosis of aneurysm of superior thyroid artery by CT and MR imaging.

A 51-year-old man presented with a nonpulsatile anterior neck mass which suggested a thyroglossal duct cyst. At CT a small cystic mass was revealed. The mass contained a well-defined, crescent-shaped, low-density area with homogeneous contrast enhancement. On MR T2-weighted spin-echo and gradient-echo images the mass was as hyperintense as the neck vessels. Angiography and operation confirmed an aneurysm of the left superior thyroid artery with a mural thrombus.     

甲状舌管囊肿的CT诊断(附12例报告)

目的　探讨甲状舌管囊肿CT表现及手术病理的关系。方法　分析 12例经手术病理证实的甲状舌管囊肿的CT、临床及手术病理资料。结果　 12例中 8例位于颈部中线 ,4例偏左侧 ,CT均表现为圆形或扁圆形囊性占位 ,5例囊壁光整 ,增强后无强化 ;7例毛糙 ,强化明显 ,镜下见炎性细胞浸润 ;8例见囊壁内结节 ,镜下为血管 ,横纹肌及结缔组织 ,较小者CT往往不能显示。结论　CT可以对甲状舌管囊肿作出正确诊断     

The CT appearance of thyroglossal duct carcinoma

BACKGROUND AND PURPOSE: Thyroid carcinoma arising in a thyroglossal duct cyst may be clinically indistinguishable from a benign thyroglossal duct cyst. The preoperative diagnosis of carcinoma, however, can have important implications for surgical planning and postoperative treatment. Our purpose was to describe the CT appearance of thyroglossal duct carcinoma and identify the features that distinguish thyroglossal duct carcinoma from benign thyroglossal duct cysts. METHODS: Retrospective review of the medical records from the University of Pittsburgh Medical Center and Geisinger Medical Center (Danville, Pennsylvania) identified six patients with papillary thyroid carcinoma within the thyroglossal duct who had undergone preoperative CT examinations of the neck. There were two women and four men. Their ages ranged from 14 to 59 years. Three patients underwent contrast-enhanced CT of the neck, and three underwent unenhanced CT. All CT examinations consisted of 3- to 5-mm-thick contiguous axial sections. RESULTS: Each patient had an anterior neck mass with a cystic component. Two of the masses had dense or enhancing mural nodules, two had irregular calcification throughout the mass, and two had dense or enhancing mural nodules with additional foci of calcification. One patient had cervical lymphadenopathy. CONCLUSION: Carcinoma should be considered in thyroglossal duct cysts that have a mural nodule or calcification or both.     

小儿颈部囊性病变的高频超声与CT表现

目的:探讨小儿颈部囊性病变的高频超声及CT表现.方法:48例经手术病理证实的颈部囊性痛变患者,均行超声和CT检查,回顾性分析其超声和CT特点.结果:48例中甲状舌管囊肿21例(43.8%),颈淋巴管瘤18例(37.5%),鳃裂囊肿9例(18.8%).颈部囊性病变各有其好发部位.甲状舌管囊肿多见于颈中线附近、舌骨上下;淋巴管瘤多见于颈侧部、锁骨上,范围较广;腮裂囊肿多见于中上侧颈部.甲状舌管囊肿及鳃裂囊肿呈单房性,淋巴管瘤多为多房性.结论:高频超声和CT检查可清晰显示病变的大小、形态和延伸范围,对颈部囊性病变具有重要的诊断和鉴别诊断价值.     

Ultrasonography and CT of thyroglossal duct cysts

A retrospective analysis of pathologically proved 7 cases of thyroglossal duct cysts was performed in an attempt to determine the characteristics of these lesions using both ultrasonography (US) and computed tomography (CT). US showed cystic mass with variable internal echoes or debris in 6 of 7 cases and internal septation in two. CT showed hypodense mass in all 4 cases of which attenuation value were higher than that of water, and rim-enhancement of the wall in one case. CT and US also showed calcification of the wall in one patient. To our knowledge, calcification of the wall of thyroglossal duct cyst was not reported previously. These findings described above may be due to complicated inflammation, and may enable to differentiate the thyroglossal duct cyst from the other neck masses.     

CT and MR imaging of fourth ventricular meningiomas

True fourth ventricular meningiomas are rare. We report two cases, one with typical CT, angiographic, and magnetic resonance (MR) appearances and one with atypical features of central cyst formation on CT and MR. The utility of MR in demonstrating intraventricular location in three imaging planes is illustrated. Given the rarity of these tumors, atypical features may preclude accurate preoperative diagnosis, even with MR.     

A thyroglossal duct cyst with calcification

We report a thyroglossal duct cyst with calcification, the second case in the world literature. The ultrasound and CT findings are described and we highlight the differential diagnosis. Received: 3 February 2000/Accepted: 8 April 2000     

脑部脉络膜裂囊肿的CT、MRI影像分析

目的:探讨脉络膜裂囊肿的影像学表现。方法:回顾分析11例脑脉络膜裂囊肿的MRI表现,其中7例行CT检查,9例行MR扫描。结果:脉络膜裂囊肿表现为圆形或类圆形、边界光滑锐利的脑脊液样低密度影或信号,增强扫描无强化。结论:脉络膜裂囊肿的CT、MRI表现较为典型,但单纯CT轴位扫描定位困难,CT多层面重建(MPR)及MRI多方位扫描有助于对其做出正确诊断。     

颈部先天性囊性肿块的CT诊断

目的:探讨颈部先天性囊肿的CT表现特点及其诊断.材料和方法:回顾性分析手术病理证实的颈部甲状舌管囊肿9例,鳃裂囊肿6例,淋巴管瘤3例的CT平扫及增强扫描表现.结果:颈部先天性囊肿表现为光滑、壁薄和无增强的肿块.甲状舌管囊肿多位于颈正中线,与舌骨关系密切,鳃裂囊肿多在胸锁乳突肌前缘,淋巴管瘤常位于颈后三角.结论:CT能准确判断颈部先天性囊性肿块的性质和位置,结合临床能准确诊断.     

超声引导下无水乙醇硬化治疗舌根部甲状舌管囊肿10例

【摘要】　目的?探讨舌根部甲状舌管囊肿超声引导下无水乙醇硬化治疗的可行性、安全性及疗效。方法?回顾性分析2014年4月—2018年4月10例患儿发生于舌根部的甲状舌管囊肿,经临床和影像学明确诊断,排除异位甲状腺的可能性,在超声引导下行无水乙醇硬化治疗。结果?10例患儿中位随访6个月,经超声和CT复查,10例囊肿均完全消失,目前无一例复发。结论?超声引导下无水乙醇治疗舌根部甲状舌管囊肿具有疗效明确,损伤小,无瘢痕,安全性高等优点,值得临床推广应用。     

后颅窝囊肿的CT－MR影像学

目的：本文目的是对后颅窝囊肿的ＣＴ－ＭＲ影像学的诊断作用进行评价。材料与方法：１２例后颅窝囊肿的ＣＴ和ＭＲ影像表现进行了分析，探讨了其与临床表现和类型的相关性。结果：本组病例包含Ｄａｎｄｙ－Ｗａｌｋｅｒ囊肿（５例）、蛛网膜囊肿（３例）和巨枕大池（４例），ＣＴ和ＭＲ都可提供无创性检测手段。结论：ＣＴ和ＭＲ二者对后颅窝囊肿的诊断均有效，但在显示病变的性状、大小和轮廓方面，ＭＲ比ＣＴ稍胜一筹     

Computed tomography of cystic neck masses

Computed tomography (CT) of the neck has been primarily applied to the assessment of malignant disease with few reports describing its utility in benign conditions. The authors report 13 cases of cystic neck masses evaluated by CT. Pathological conditions included brachial cleft cyst, laryngocele, thyroglossal duct cyst, cavernous lymphangioma, necrotic lymphadenopathy, and asymmetric jugular veins. Computed tomography was helpful in correctly predicting the etiology by determining the exact location of these masses in relation to the normal anatomic structures in the neck.     

Thyroglossal duct cyst in hyoid bone: CT confirmation

In our report we describe an atypically sited thyroglossal cyst in a 67-year-old woman. The intrahyoid location is explained by one of the theories of the migration of the rudimentary thyroid during embryogenesis. The diagnosis was confirmed by CT.     

三叉神经纤维瘤的影像学诊断（附13例分析）

目的：探讨X光片、CT、MR检查对三叉神经纤维瘤的诊断价值。材料与方法：选择13例经手术和病理证实的三叉神经纤维瘤病人的X光手片、CT、MR分析其影像学改变。结果：本病X光平片的特征表现为颅底骨质破坏或卵园孔扩大。本病的CT检查特征为，病变位于中颅凹，岩骨尖处病变呈园形或类园形，多有囊变、增强扫描病灶强化明显。可以同时发现颅底骨质破坏。本病的MR检查特征为长T1，长T2信号，其中T1为低信号，T2为高信号，其中信号不均匀，可以发现囊实性肿瘤。结论：三叉神经纤维瘤的病人经过X光平片、CT、MR检查可以在术前明确诊断。     

Magnetic resonance imaging of an epidural spinal arachnoid cyst

The myelography, CT and MR imaging findings in a patient with an epidural spinal arachnoid cyst are discussed. MR imaging excellently demonstrated cyst size, cyst location and cord compression, and should be the method of choice in these cases.     

Primary muscular hydatidosis. US,CT and MR findings

We present a rare case of primary muscular hydatidosis in the left thigh of a 40-year-old female patient. US, CT and MR imaging showed a typical multilocular hydatid cyst deep in the vastus intermedius and vastus medialis muscles. Histopathological examination, which followed surgical excision, established the diagnosis of echinococcus cyst.     

Thyroglossal duct cyst carcinoma: case report and review of the literature, with emphasis on CT findings

Carcinoma arising in a thyroglossal duct cyst (TDC) is rare. To the best of our knowledge, 155 cases have been reported, 12 of which were studied with CT. The diagnosis is established after surgical excision of the lesion but CT findings may raise the suspicion of malignancy. We present a case of TDC carcinoma and a review of the literature, with emphasis on CT findings. Received: 5 March 1999 Accepted: 20 October 1999