表皮样囊肿声像图特点与病理改变的关系

目的探讨表皮样囊肿的超声成像特点与病理组织学的关系。方法回顾分析21例经手术病理检查证实的表皮样囊肿的不同超声图像特征及其与病理改变的关系。结果21例表皮样囊肿患者基本具有3种超声特征表现:(1)肿块内部回声均质型(17例):病理改变为囊肿内部角质上皮相对偏少,呈层状分布;(2)肿块内部回声不均质型(3例):病理显示囊壁有破裂,囊内角质上皮、坏死鳞状上皮紊乱分布,并有纤维化、钙化等多种表现;(3)肿块内部回声呈强弱相间的螺纹征型(1例):病理显示呈同心圆层状分布的致密角质层和坏死鳞状上皮细胞。结论表皮样囊肿具有较典型的超声表现,其声像图特征与不同病理组织学改变相对应。内部回声均质是表皮样囊肿最常见的声像图特征。     

二维灰阶超声联合超声造影对睾丸表皮样囊肿的诊断价值

探讨二维灰阶超声联合超声造影(CEUS)对睾丸表皮样囊肿的诊断价值。方法 选择2009年7月至2015年12月空军军医大学第一附属医院收治的经手术组织病理证实为睾丸表皮样囊肿的47例患者,回顾性分析患者检查的声像图资料,分析超声术前诊断睾丸表皮样囊肿的准确度。结果 二维超声术前诊断睾丸表皮样囊肿准确度为85.71%(42/49),二维灰阶联合CEUS诊断准确度为93.88%(46/49)。结论 二维灰阶联合CEUS对睾丸表皮样囊肿诊断价值较高。     

248例皮肤囊肿的超声诊断价值与误诊原因探讨

摘要 目的：比较超声与病理诊断皮肤囊肿的符合率，探讨各类皮肤囊肿的诊断特点与误诊因素。方法：对248例超声诊断的3类皮肤囊肿与病理对比分析。结果：248例超声诊断皮肤囊肿，符合病理诊断210例，不符合诊断38例，超声总符合率85%，其中表皮样囊肿225例（与病理诊断结果相比符合率86％），皮脂腺囊肿15例（66%），脂囊瘤8例（88%），多数皮肤囊肿有各自超声特征性表现，但部分缺乏特异性。结论：高频超声对大多数皮肤囊肿能做出正确的定性诊断，且可作出准确定位，对不典型表现者需全面细致观察、结合临床资料来提高诊断率。     

桥小脑角表皮样囊肿的磁共振影像表现及其扫描技术分析

目的分析桥小脑角表皮样囊肿的磁共振成像(MRI)表现,探讨磁共振(MR)扫描技术在桥小脑角表皮样囊肿诊断中的价值。方法回顾性分析12例桥小脑角表皮样囊肿的MR扫描技术及MRI表现。结果 12例中1例T1WI呈高信号,其余T1WI呈低信号。所有病例T2WI均呈高信号,稍高于脑脊液。9例FLAIR囊内见不同数量的絮状稍高信号影,其中有2例仅在边缘出现少量絮状等高信号影。DWI均表现为明显高信号,信号不均匀。结论桥小脑角表皮样囊肿MRI表现具有特征性,MRI对本病的诊断与鉴别诊断具有价值,联合应用DWI和T2 FLAIR有利于桥小脑角皮样囊肿的诊断。     

Pontomedullary white epidermoid: a rare cause of tinnitus

Intracranial epidermoid cysts are relatively rare congenital inclusion cysts. They are the third most common cerebellopontine angle cistern mass after vestibular schwannoma and meningioma. White epidermoid is a rare variant. We present the first case, to our knowledge, of a white epidermoid cyst anterior to the pontomedullary junction, emphasising its imaging appearance, location and the importance of pre-operative diagnosis, which may reduce operative complications.     

颅内表皮样囊肿MRI诊断15例

目的 分析颅内表皮样囊肿的MRI表现.方法 收集经手术病理证实的颅内表皮样囊肿15例,重点分析肿瘤的好发部位、大小形态及MRI扫描与增强扫描的信号特点.结果 在本组病例中,桥小脑角区8例,鞍旁2例,斜坡区2例,枕骨1例,侧脑室三角部、第四脑室各1例.肿瘤在T1加权像上呈不均匀低信号,T2加权像、FLAIR图像上呈不均匀高信号,所有病例均行增强扫描,肿瘤均无强化.结论 典型的颅内表皮样囊肿的MRI表现具有特征性,MRI检查可以作出准确诊断,并能与其他类似的颅内囊性病变相鉴别.     

颅内表皮样囊肿的临床特征及显微手术治疗

目的对1994～2004年完成的颅内表皮样囊肿显微外科手术进行总结,为此种疾病今后的诊断和治疗提供有益的参考。方法对本院12例颅内表皮样囊肿患者,先行CT和MRI检查,随后在全麻下进行显微外科的手术切除。以电凝切开囊膜,将囊内实质逐步摘除,然后沿边界细心分离,逐一电凝并切断血供及粘连,彻底切除囊肿。对于粘连过于紧密的部位,宁可残余少量组织,以免出现术后严重的并发症。并在术后对患者的检查资料进行总结,对病变组织进行影像学和病理学分析。结果12例颅内表皮样囊肿患者中,8例位于桥小脑角,颅底斜坡2例,鞍区1例,脑室1例。手术切除的囊肿组织,75％(9／12例)呈不规则形态。CT平扫83．33％(10／12例)为均匀低密度,且造影后90％(9／10例)未发生强化MRI T1呈均匀低信号,与脑脊液基本类似或略高于脑脊液,T2呈均匀高信号,占75％(9／12例)。周围脑组织未发现有水肿现象;但是当瘤体较大时会引起比较明显的占位效应,占66．67％(8／12例)。结论颅内表皮样囊肿在CT和MRI检查中可见有特征性表现,为手术提供较为准确的术前诊断,术中观察和术后的病理切片均得以证实。经过显微外科手术,基本可以完全切除囊肿组织,达到较好的治疗效果。     

磁共振弥散加权成像对表皮样囊肿鉴别诊断的帮助

目的：评价弥散加权成像在诊断表皮样囊肿中的作用。方法：对17例经手术病理证实的表皮样囊肿和6例蛛网膜囊肿行常规MRI扫描和弥散加权成像。结果：表皮样囊肿在弥散加权为高信号,蛛网膜囊肿为低信号。结论：弥散加权成像对鉴别表皮样囊肿有较高的应用价值。     

Laparoscopic partial splenectomy for large splenic epidermoid cyst

Splenic epidermoid cysts are relatively rare lesions traditionally treated by splenectomy. Concerns about overwhelming postsplenectomy sepsis have led to the development of splenic preservation procedures in the treatment of cystic diseases of the spleen. Better understanding of the splenic segmental anatomy and advances in laparoscopic skills has made laparoscopic partial splenectomy a preferred treatment for splenic cysts while preserving splenic function. We reported a case of a 30-year-old male patient with a large epidermoid splenic cyst managed successfully by laparoscopic partial splenectomy. The patient recovered well after operation and was asymptomatic on a follow-up of 1 year with no recurrence on ultrasonography and a normal platelet count. Laparoscopic partial cystectomy is an acceptable procedure for the treatment of splenic cysts which locate in the pole of spleen. On the one hand, it cures the disease preserving the splenic tissue without risk of bleeding or recurrence; on the other hand, this minimally invasive technique induces a reduced hospital stay and a more rapid recovery.     

腹腔镜部分脾切除治疗巨大脾表皮样囊肿一例

Splenic epidermoid cysts are relatively rare lesions traditionally treated by splenectomy. Concerns about overwhelming postsplenectomy sepsis have led to the development of splenic preservation procedures in the treatment of cystic diseases of the spleen. Better understanding of the splenic segmental anatomy and advances in laparoscopic skills has made laparoscopic partial splenectomy a preferred treatment for splenic cysts while preserving splenic function. We report a rare case of a 30-year-old male patient with a large epidermoid splenic cyst managed successfully by laparoscopic partial splenectomy. The patient recovered well after operation and was asymptomatic on a follow-up of 1 year with no recurrence on ultrasonography and a normal platelet count. Laparoscopic partial cystectomy is an acceptable procedure for the treatment of splenic cysts which locate in the pole of spleen. On the one hand, it cures the disease preserving the splenic tissue without risk of bleeding or recurrence; on the other hand, this minimally invasive technique reduces hospital stay and the patient recovery rapidly.     

磁共振DWI在颅内表皮样囊肿和脑脓肿中的诊断价值

目的评价弥散加权成像（DWI）以及表观弥散系数（ADC）值在颅内表皮样囊肿和脑脓肿诊断中的应用。方法 15例经手术病理证实的颅内表皮样囊肿和12例经手术病理或临床随访证实的脑脓肿,在术前或治疗前均接受了常规MRI及DWI检查（弥散敏感系数即b值采用：b=0s/mm2及b=1000s/mm2）,测量颅内表皮样囊肿、脑脓肿、正常深部脑白质区以及脑脊液（CSF）的ADC值,并计算其平均值。结果颅内表皮样囊肿和脑脓肿在DWI上表现为明显高信号。颅内表皮样囊肿的ADC值低于CSF（P〈0.01）,高于脑白质（P〈0.05）;脑脓肿的ADC值显著低于CSF（P〈0.01）,也低于脑白质（P〈0.05）。结论 DWI以及ADC值在颅内表皮样囊肿和脑脓肿的诊断与鉴别诊断中具有重要作用,可作为常规MRI序列的重要补充。颅内表皮样囊肿和脑脓肿在DWI上表现为明显高信号,前者是由于T2透过效应,后者是由于扩散受限所致。     

Laparoscopic partial splenectomy for large splenic epidermoid cyst

Splenic epidermoid cysts are relatively rare lesions traditionally treated by splenectomy. Concerns about overwhelming postsplenectomy sepsis have led to the development of splenic preservation procedures in the treatment of cystic diseases of the spleen. Better understanding of the splenic segmental anatomy and advances in laparoscopic skills has made laparoscopic partial splenectomy a preferred treatment for splenic cysts while preserving splenic function. We reported a case of a 30-year-old male patient with a large epidermoid splenic cyst managed successfully by laparoscopic partial splenectomy. The patient recovered well after operation and was asymptomatic on a follow-up of 1 year with no recurrence on ultrasonography and a normal platelet count. Laparoscopic partial cystectomy is an acceptable procedure for the treatment of splenic cysts which locate in the pole of spleen. On the one hand, it cures the disease preserving the splenic tissue without risk of bleeding or recurrence; on the other hand, this minimally invasive technique induces a reduced hospital stay and a more rapid recovery.

     

口腔颌面部软组织发育性囊肿的诊断与治疗——附94例临床分析

<正> 口腔颌面部囊肿,按Lucas分类为骨内囊肿(包括面裂囊肿、牙源性囊肿和非上皮性骨囊肿)和软组织囊肿(包括潴留囊肿和发育性囊肿)。本文只讨论软组织发育性囊肿,即鼻唇囊肿、龈囊肿、甲状舌管囊肿、鳃裂囊肿、畸胎样囊肿、皮样和表皮样囊肿的临床诊断和治疗。     

颅底中央区巨大表皮样囊肿显微外科治疗

目的:探讨颅底中央区巨大表皮样囊肿显微外科治疗的临床疗效.方法:回顾性分析显微外科手术治疗颅底中央区巨大表皮样囊肿36例的临床特点和手术体会.结果:36例颅底中央区巨大表皮样囊肿中,手术全切除32例,次全切除4例,颅神经损伤或症状加重13例,无手术死亡.结论:根据表皮样囊肿累及的部位,选择好手术入路和运用好显微外科技术可提高手术的全切率,降低并发症.     

浅表组织表皮样囊肿的声像图分析

目的分析全身浅表组织表皮样囊肿的声像图特点。方法回顾性分析36例浅表器官表皮样囊肿的患者临床资料,对其形态、大小、位置、内部回声、边界、包膜、后方回声、有无感染及血流情况进行分析。结果 36例中肿块位置均位于皮下,有包膜,边界清,内部回声不均,成细密点状回声,后方回声略增强,肿物内部无血流信号。病理结果显示肿物切面为囊性,壁较薄,囊内表面光滑,囊内为灰白色豆渣样物。结论表皮样囊肿声像图具有一定特征性,高频超声具有较高的诊断价值。     

Splenic epidermoid cyst

Splenic epidermoid cyst is a rare cystic disease affecting the spleen. We report a young male who presented with a painless abdominal lump. Ultrasonography and CT scan of abdomen showed a huge cystic lesion of obscure origin. At laparotomy a huge cyst was found to be arising from the superior pole of the spleen, and its removal necessitated splenectomy. Histopathological findings were consistent with splenic epidermoid cyst. The aetiopathology and different treatment modalities of splenic cysts are discussed. Key words: splenic cyst, epidermoid cyst, pseudocyst, splenectomy.     

桥小脑角胆脂瘤的显微外科治疗

目的：总结桥小脑角(CPA)胆脂瘤的显微外科手术入路和神经内镜辅助手术。方法：28例桥小脑角胆脂瘤，采用枕下开颅乙状窦后入路16例、颞枕开颅颠下小脑幕入路10例、颞枕开颅幕上下联合入路2例。其中5例手术应用神经内镜辅助。结果：肿瘤全切除21例，近全切除7例，无手术死亡。结论：枕下开颅乙状窦后入路适用于胆脂瘤位于CPA以及由CPA向斜坡生长者；颞枕开颅颞下小脑慕入路适用于CPA胆脂瘤向岩骨尖斜坡及幕上鞍区发展者；巨大胆脂瘤同时累及CPA、鞍区和下斜坡时采用颞枕开颅幕上下联合入路。神经内镜辅助有助于减小手术创伤，提高肿瘤全切率。     

磁共振扩散加权成像在临床脑肿瘤中的应用分析

目的分析磁共振扩散加权成像(DWI)在脑肿瘤临床诊断中的应用价值。方法对40例脑脓肿、52例胶质瘤、58例转移瘤、28例表皮样囊肿、52例蛛网膜囊肿进行常规MR、DWI成像、表观扩散系数(ADC)测量和增强MR检查,分析其影像学表现。结果脑脓肿、胶质瘤和转移瘤全部强化,表现为环状或花环状强化;表皮样囊肿、蛛网膜囊肿病例不强化。DWI上32例脑脓肿和28例表皮样囊肿呈高信号;52例蛛网膜囊肿均为低信号;110例脑肿瘤患者中,10例胶质瘤呈高信号,26例呈混杂信号,其中20例为胶质瘤,6例转移瘤,其余均为低信号。结论 MR扩散加权成像及增强磁共振在颅内囊性病变的定性诊断中意义重大。     

Splenic epidermoid cysts presenting as an acute abdomen

Two patients with splenic epidermoid cysts who presented as acute abdominal emergencies are reported.     

颅内皮样囊肿和表皮样囊肿的MRI鉴别诊断

目的：探讨颅内皮样囊肿及表皮样囊肿的MRI表现及其诊断价值。方法：回顾性分析5例经手术病理证实的颅内皮样囊肿和7例颅内表皮样囊肿病例,对其MRI表现、病理和临床特征进行分析。其中8例行MRI增强扫描。结果：5例颅内皮样囊肿病例中,3例表现为T1WI低信号,T1WI为高信号,2例T1WI及T2WI均为不均匀高信号。增强扫描的3例均表现为厚壁中等强化。7例颅内表皮样囊肿病例中,4例表现为T,WI低信号,T2WI高信号,2例TlWI及T2WI均为高信号,l例T1WI及T2WI均为不均匀高信号。增强扫描的5例中4例表现为薄壁轻微强化,1例壁无强化。结论：颅内皮样囊肿和表皮样囊肿均有较典型的MRI表现,可实现术前正确诊断,MRI鉴别诊断意义重大。