颈外侧部肿块的影像学诊断与鉴别诊断

目的 分析各种颈外侧部肿块增强扫描前后的CT、MRI表现.资料与方法 回顾性分析45例经病理证实的颈外侧部肿块增强扫描前后的CT、MRI表现,包括病灶的部位、大小、形态、边缘、密度、信号、强化特点及其与邻近血管和间隙的关系.结果 45例颈外侧部肿块中,鳃裂囊肿6例,淋巴管瘤6例,淋巴结结核6例,淋巴结转移瘤8例,颈动脉体瘤3例,淋巴瘤2例,淋巴结炎4例,神经鞘瘤5例,颈部脓肿、巨大淋巴结增生、神经纤维瘤,原始神经外胚层肿瘤、海绵状血管瘤各1例.鳃裂囊肿、淋巴管瘤表现为囊性无强化；颈部脓肿表现为环形强化；淋巴结结核、淋巴结转移瘤表现为结节状轻中度强化与环形强化共存；淋巴瘤、淋巴结炎、巨大淋巴结增生、神经纤维瘤、神经鞘瘤、原始神经外胚层肿瘤呈轻中度强化；海绵状血管瘤、颈动脉体瘤呈高度强化.结论 颈外侧部肿块增强前后CT、MRI表现有特征性改变,可作出较为准确的诊断.

Imaging Diagnosis and Differential Diagnosis of the Lateral Neck Masses

Purpose To summarize the imaging findings of the lateral neck masses on CT and MRI images with and without contrast enhancement.Materials and Methods The CT and MRI images of 45 patients with lateral neck mass confirmed pathologically were retrospectively analyzed.The tumor location,size,shape,margin,density,signal intensity,contrast enhancement and the relationships with adjacent vasculature and space were recorded for each tumor.Results Out of the 45 cases with lateral neck mass,there were 6 cases of branchial cleft cyst,6 cases of lymphangioma,6 cases of lymph node tuberculosis,8 cases of lymph node metastasis,3 cases of carotid body tumor,2 cases of lymphoma,4 cases of lymphadenitis,5 cases of schwannoma,and 1 case of abscess,Castleman’s disease,neurofibiroma,primitive neuroectodermal tumor,and hemangioma,respectively.Branchial cleft cyst and lymphangioma presented as cystic mass without enhancement.Cervical abscess presented ring enhancement.Both nodular mild or moderate enhancement and ring enhancement were presented in lymph node tuberculosis and metastasis.There were mild to moderate enhancement in lymphoma,lymphadenitis,Castleman’s disease,neurofibroma,schwannoma and primitive neuroectodermal tumor.There were intensive enhancement for hemangioma and carotid body tumor.Conclusion There are some characteristic features in CT and MRI images with and without contrast enhancement,which can be helpful for correct diagnosis.