鳃裂囊肿和瘘管的影像诊断

Imaging Diagnosis of Branchial Cleft Cyst and Fistula

目的认识鳃裂囊肿影像学表现和提高诊断准确率。材料和方法回顾分析了经临床诊治,以及手术、病理证实的鳃裂囊肿和瘘管21例的超声、CT、MRI表现。结果①12例超声检查表现为颈中、上部两侧与胸锁乳突肌、颌下腺、腮腺、颈鞘血管关系密切的低回声囊肿或囊实性病灶。②10例CT检查表现为位于颈前三角区、胸锁乳突肌前缘的囊性肿块;合并感染时,病灶边界模糊,囊内密度增高,囊壁强化。③1例MRI检查表现为颈侧部、胸锁乳突肌深面、下颌角后下方、颈动静脉外侧的囊性肿物,为短T1长T2信号,边缘异常对比增强,与周围组织界限清。仅有1例第一鳃裂瘘管未能显示。结论超声的诊断价值有限,CT和MRI显示病变的位置、范围、形态、密度和信号较佳,多断面成像和信号变化使MRI在诊断中更有价值。

Purpose:To recognize the imaging characteristics of branchial cleft cyst(BCC)and fistula and improve the rate of diagnosis accuracy.Materials and Methods:We reviewed retrospectively the US,CT and MRI findings of21BCC and fistula proved clinically,surgically and pathologically.Results:①US:those lesions were showed as low echo systo-solid ones.They located in both sides of the upper and middle neck ane closed to the sternocleidomastoid muscle,submaxillary gland,parotid gland,and carotid,jugular vein.②CT:those lesions were showed as cystic ones in the anterior triangle area of the neck or along the anterior border of the sternocleidomastoid muscle.The infection was suggested when its border was not clear,its internal density of cyst was increased and its cystic wall was enhanced.③MRI:those leˉsions were showed as cystic masses in the lateral neck,the deep part of the sternocleidomastoid muscles,the posterointerior area of the mandibles and the lateral area of carotid and jugular veins.They were low signal intensity ones on T 1 WI images and high signal intensity ones on T 2 WI images.Their edged were well-defined enhancement.There were clear borders between those lesions and their peripheral strucˉtures.A case of the first bronchial cleft fistula was not displayed.Conclusion:US has little value for those lesions.CT and MRI can show better about those lesions’location,range,appearance,density and signal intensity.Multislice images and signal changes made MRI to be more valuable for diagnosis accuˉracy.