Thyroglossal duct cysts: sonographic appearances in adults.

BACKGROUND AND PURPOSE: Previous reports have suggested that thyroglossal duct cysts (TDCs) appear on sonograms as well-defined cystic masses with thin walls and posterior enhancement. In our experience, however, TDCs have a variable sonographic appearance. We report our findings in 40 patients with TDCs and document the variability of sonographic patterns. METHODS: All patients in whom the diagnosis of TDC was made clinically (by at least two head and neck surgeons) and sonography detected a cystic mass related to the hyoid bone were included in this study. Sonograms of 40 patients with TDCs were reviewed. The features evaluated were the location, internal echogenicity, posterior enhancement, presence of septa, solid component, and fistulous tract. The echo pattern was not compared with the biopsy results. RESULTS: Four patterns of TDCs were identified: anechoic (28%), homogeneously hypoechoic with internal debris (18%), pseudosolid (28%), and heterogeneous (28%). The majority showed posterior enhancement (88%), were midline (63%), and infrahyoid in location (83%). Only half of all TDCs showed a typical thin wall. CONCLUSION: On sonograms, TDCs in adults are not simple cysts, as previously suggested, but have a complex pattern ranging from a typical anechoic to a pseudosolid appearance.     

鳃裂囊肿的少见MRI表现

目的 报告鳃裂囊肿的不常见MRI表现，以提高对该病的认识。方法 分析10例经手术病理证实的鳃裂囊肿的MR／表现。男6例，女4例。年龄15-70岁，平均37．4岁。全部病例均行术前MR平扫检查。其中6例还作了增强检查，4例作了颈部磁共振血管造影。结果 10例均为第2鳃裂囊肿，其中Bailey Ⅰ型4例，Bailey Ⅱ型6例。少见的MR／表现包括囊内出血（2例）、囊壁异常增厚（4例）、囊液固化（2例）及合并癌变（2例），这些表现使MR／诊断产生困难。结论 MR／形态或信号表现不典型的鳃裂囊肿，诊断时需结合其发病位置，以下颌角、胸锁乳突肌前缘等典型部位最有帮助。如出现囊壁增厚、边缘不清以及周围血管累及或颈部淋巴结肿大等征象时，则高度提示癌变。     

鳃裂囊肿的MRI和CT诊断

目的：讨论鳃裂囊肿的ＭＲ和ＣＴ表现及其诊断价值。方法：对均经手术和病理证实的１１例鳃裂囊肿病人（第一鳃裂囊肿２例,第二鳃裂囊肿９例）的ＣＴ或ＭＲＩ的表现进行分析,并结合文献进行讨论。结果：第一鳃裂囊肿表现为耳前区反复感染或瘘,其特征为瘘道与外耳道平行;第二鳃裂囊肿常表现为颈外侧部和颌下区无压痛囊性肿块,ＣＴ和ＭＲＩ表现为薄壁、均质的囊性肿块,胸锁乳突肌受压向后外或向后移位,颈动脉间隙大血管向内或向     

Second branchial cleft cyst with "cyst-within-cyst" appearance

A 68-year-old female consulted our hospital, complaining of a large mass on the left side of the neck. Computed tomography and magnetic resonance imaging revealed the characteristic internal architecture of the mass, in which a small cyst was located within a cystic mass, showing a "cyst-within-cyst" appearance. A final diagnosis of second branchial cleft cyst was made pathologically. A "cyst-within-cyst" appearance is not usually seen in a second branchial cleft cyst. This appearance may be attributed to several fine-needle aspiration biopsies for diagnostic purposes.     

Diagnosis and differential diagnosis of branchial cleft cysts by CT scan

The author stresses the importance of CT scanning in diagnosing branchial cleft cysts (BCCs) and in differentiating them from other cystic masses of the neck and parotid region. The CT examinations of 40 patients with neck or parotid cystic lesions suspected of being BCCs have been reviewed and correlated with the histological diagnosis. Sixteen BCCs (12 of the second and 4 of the first cleft) and 24 BCC mimics were evaluated. A definitive CT diagnosis of second BCC was possible in 83% of the cases. Exclusion of this diagnosis was possible in 94% of BCC mimics. The total accuracy of CT was 90%. Differentiation of first BCCs from their mimics is more difficult. Most first BCCs are located juxta-parotidal and at the lower pole of the parotid gland.     

Granulomatous mastitis: mammographic and sonographic appearances.

OBJECTIVE: The objective of our study is to describe the mammographic and sonographic appearances of granulomatous mastitis. CONCLUSION: Granulomatous mastitis can mimic breast carcinoma clinically and mammographically, but the sonographic appearance of multiple clustered, often contiguous tubular hypoechoic lesions that are sometimes associated with a large hypoechoic mass should suggest the possibility of granulomatous mastitis.     

The sonographic appearances in postpartum thyroiditis.

During the postpartum period about 50% of women with circulating thyroid autoantibodies develop a transient autoimmune thyroiditis. To determine the sonographic appearances in postpartum thyroiditis (PPT), serial ultrasound (US) scans of the thyroid were performed in 135 postpartum women who were divided into three clinical groups: Group 1, 37 antibody positive subjects who developed PPT; Group 2, 28 antibody positive subjects in whom thyroid function remained normal; Group 3, 70 antibody negative controls. Thyroid hypoechogenicity was observed in 14/31 patients (45%) who were scanned between 4 and 8 weeks postpartum and who subsequently developed PPT (Group 1) compared with 4/24 patients (17%) in Group 2 (P less than 0.05) and 1/65 patients (1.5%) in Group 3 (P less than 0.001). In antibody positive patients, the positive predictive value of an abnormal scan during this period was 78%. Between 15 and 25 weeks postpartum thyroid hypoechogenicity was present in 32/37 patients (86%) in Group 1 compared with 11/28 patients (39%) in Group 2 (P less than 0.001) and 2/70 patients (3%) in Group 3 (P less than 0.001). Sonographic abnormality persisted beyond 32 weeks postpartum in 36/41 antibody positive patients (87%) who had exhibited thyroid hypoechogenicity earlier during the study and who had late scans. The characteristic US appearance in PPT is thyroid hypoechogenicity. The role of sonography in the prediction, diagnosis and follow up of patients with PPT is discussed.     

Pancreatic changes in cystic fibrosis: CT and sonographic appearances

The computed tomographic (CT) and sonographic appearances of the late stages of pancreatic damage in three patients with cystic fibrosis are illustrated. All three had severe exocrine pancreatic insufficiency with steatorrhea. In two patients CT revealed complete fatty replacement of the entire pancreas. In the third, increased echogenicity of the pancreas on sonography and the inhomogeneous attenuation on CT were interpreted as being the result of a combination of fibrosis, fatty replacement, calcification, and probable cyst formation.     

Mammographic and sonographic appearances of nodular adenosis

OBJECTIVE: We determined whether nodular adenosis of the breast possesses any pathognomonic features on imaging studies. CONCLUSION: The imaging features of nodular adenosis are often benign-appearing and can be indistinguishable from other ellipsoid, circumscribed, or hypodense masses. Occasionally, nodular adenosis may appear suggestive of malignancy. Pathologic evaluation by excisional or large core needle biopsy is necessary for diagnosis.     

鳃裂囊肿的CT诊断

目的：探讨鳃裂囊肿的CT表现及鉴别诊断。方法：收集手术病理证实的鳃裂囊肿12例，分析其CT表现并结合文献进行讨论。结果：根据Bailey的分型，本组12例中属Ⅰ型有5例，Ⅱ型有7例。表现为边界清晰、密度均匀的囊样肿块。结论：CT可显示囊肿的部位、大小及范围，结合临床特点可作出诊断。     

Ultrasound appearances of testicular epidermoid cysts

Benign testicular tumours are uncommon but if recognized can enable a conservative approach to surgery to be recommended. This pictorial review demonstrates the variety of sonographic appearances of testicular epidermoid cysts correlating them with pathological findings in 19 lesions, the largest reported imaged series to date. Atchley, J. T. M., Dewbury, K. C. (2000). Clinical Radiology 55, 493-502.     

Simple pancreatic cysts: CT and endosonographic appearances

OBJECTIVE. This report describes the CT and endoscopic sonographic appearance of simple pancreatic cysts in three adults. CONCLUSION. Simple pancreatic cysts are typically an incidental finding in adults who have no history of pancreatic disease. The imaging characteristics of simple pancreatic cysts on CT and endosonography are similar to those of benign cysts.     

鳃裂囊肿的CT诊断

目的：探讨鳃裂囊肿的CT表现及其诊断价值。方法：收集我院CT诊断并经手术治疗的鳃裂囊肿15例，复习有关献，对其CT征象进行分析。结果：本组鳃裂囊肿均位于胸锁乳突肌上1/3的前缘，相当于舌骨平面，颈动脉鞘的外侧，左侧8例，右侧7例。注射造影剂后无强化现象。囊肿与周围结构界限清楚。囊肿邻近结构有不同程度受压移位。结论：CT可定位定性地诊断鳃裂囊肿，对指导临床治疗有很高的价值。     

The sonographic appearances of small bowel tumours.

Twenty-seven cases of small bowel tumour confirmed surgically and pathologically have been studied. The sonographic appearances are described as well as a method of ultrasound detection following water ingestion. Tumours were classified into: (i) intraluminal tumours (duodenal adenocarcinoma n = 5; distal ileal lipoma with intussusception, n = 1; (ii) intramural tumours (proximal jejunal adenocarcinoma, n = 2; jejuno-ileal lymphoma, n = 5; (iii) extraluminal tumours (duodenal leiomyosarcoma, n = 2; neurilemmoma, n = 1; jejuno-ileal leiomyoma, n = 4; leiomyosarcoma, n = 6; subserosal lymphangioma, n = 1). Observing the lesion intermittently over a period of 1 h after water ingestion improves the localization of tumours within the small bowel.     

The variable sonographic appearances of ovarian teratomas: correlation with CT

To better understand how the internal composition of ovarian teratomas influences their sonographic features, we compared their sonographic and CT appearances in 23 cases. Sixteen lesions had a mixed echo texture, with hypoechoic as well as echogenic components; two were anechoic and five were entirely echogenic. Correlation with the CT images showed that the fat present in most teratomas had variable sonographic appearances. Pure sebum was anechoic or hypoechoic, but fat intermixed with hair strands was echogenic and often attenuated the sound beam because of the numerous tissue interfaces created within the mass. The hypoechoic component of the teratoma corresponded, on CT, to low-attenuation fat in 12 tumors and to fluid in five. Most teratomas contained a dermoid plug, a protuberance arising from the tumor wall and containing hair follicles and often fragments of bone or teeth. On sonography, all dermoid plugs were seen as an echogenic mass, often associated with distal acoustic shadowing and protruding into the hypoechoic portion of the teratoma. When the dermoid plug was large and occupied most of the tumor, the entire teratoma appeared echogenic, with no discernible anechoic component. We found that three factors greatly affected the sonographic appearance of ovarian teratomas: the size of the dermoid plug, the presence and location of calcified elements, and the histologic composition of the fatty component.