鳃裂囊肿的少见MRI表现

The non-typical MRI findings of the branchial cleft cysts

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。

Objective To investigate the non-typical MRI findings of the branchial cleft cysts in order to improve their diagnoses. Methods 10 cases with branchial cleft cysts proven by surgery and pathology were collected and their MRI features were analyzed. There were 6 male and 4 female, aged 15 to 70, with an averaged age of 37. All patients underwent plain MR scan, 6 patients underwent enhanced scan, and 4 patients underwent magnetic resonance angiography. Results All 10 cases were second branchial cleft cysts, including 4 of Bailey type Ⅰand 6 of type Ⅱ. The non-typical MRI findings were composed of haematocele （2 cases）, extraordinarily thick cyst wall （4 cases ）, solidified cystic fluid （2 cases）, and concomitant cancerafion （2 cases）, which made the diagnoses more difficult. Condusion The diagnoses of the branchial cleft cysts with non-typical MRI features should combined with its characteristic of position that located at the lateral portion of the neck adjacent to the anterior border of the stemocleidomastoid muscle at the mandibular angle. The findings, such as thickened wall, ill-defined margin, and vascular involvement or jugular lymphadenectasis, strongly suggest cancerous tendency.