颈部间隙囊性肿块的CT和MRI诊断

目的分析颈部囊性肿块的MR I和CT特征。方法回顾性分析44例经手术病理证实的颈部囊性肿块,其中淋巴结病变12例,脓肿2例,涎腺病变4例,神经鞘瘤3例,甲状舌管囊肿7例,鳃裂囊肿9例,囊性水瘤5例,皮样囊肿1例,喉气囊肿1例。结果增强CT和MR I可以显示肿块的囊性特征。淋巴结病变为液化坏死所致,有较厚的囊壁;涎腺囊性病变表现各异;先天性囊肿常表现为光滑、薄壁和无增强的肿块,多数囊肿具有特定的解剖位置,如甲状舌管囊肿主要位于颈前中线和舌骨水平,第二鳃裂囊肿多位于颌下腺后方和颈动脉间隙外侧,囊性水瘤最常见于颈后间隙,皮样囊肿位于口底。结论MR I和CT影像学检查能准确评价肿块的性质和位置,对诊断和术前理想方案制订具有重要价值。

CT and MRI Diagnosis of Cystic Masses of Neck

Objective To investigate CT and MRI findings of cystic masses of the neck.Methods 44 cases with cystic neck lesionsincluding lymphadenopathy 12,abscesses2,nerve sheath tumors 3,salivary lesions 4,thyroglossal duct cysts 7,branchial cleft cysts 9,cystic hygromas 5,dermoidcyst 1 and laryngeal mucocele 1 comfired by operation-pathology were analysed.Results The cystic features of lesions could be showed on contrast-enhanced CT and MRI,cystic alteration in lymphadenopathy were due to necrosis and presented as the cystic wall enhanced and thickened.Salivary cystic lesions were variable.Congenital cystic masses usually appeared as a smooth,well-circumscribed mass,the cystic wall was thin and nonenhanced unless inflammation was present and most of them localized at the specificanatomic compartments.Thyroglossal duct cysts were mainly in the anterior midline portion of the neck at the level of the hyoid bone.Second branchial cleft was commonly in the posterior margin of the submandibular gland and lateral to the carotid space.Cystic hygroma was most commonly found in the posterior cervical space.Dermoid cyst presented in the floor of the mouth.Conclusion CT and MRI can provide essential informations in evaluating the nature and location of the cystic mass of neck,which is of significance for diagnosis and preoperative planning.