颈外侧部肿块的CT诊断和鉴别诊断

CT diagnosis and differential diagnosis of the masses in lateral district of neck

目的分析颈外侧部肿块的CT表现特征、影像相关的病理解剖学基础,进一步提高对颈外侧部各类肿块的认识。方法回顾分析52例经病理学证实的颈外侧部肿块CT增强表现,包括病灶的大小、形态、密度、边缘、强化特征、肿块所在的解剖部位及其邻近血管和间隙的关系等。结果52例颈外侧部肿块中位于茎突前间隙8例,腮腺区8例,嚼肌间隙2例,颈动脉间隙34例。多数颈外侧部肿块的病理改变和解剖关系能在CT上反映,依据肿块引起附近间隙、肌肉、血管等移位方向,可推断肿块的来源,不同来源的肿块与颈动静脉的位置关系有解剖上的相关性。结论CT是颈外侧部肿块定位诊断的有效手段,根据病变所在的解剖平面、强化特点及其与颈部血管间的相互关系有利于定性诊断和鉴别诊断。

Objective To analyze the CT findings and the corresponding anatomic basis of the masses arising in the lateral district of neck, and improve the diagnosis. Methods CT findings in 52 patients with tumours in lateral district of neck, pathologically proved, were retrospectively studied on the size of the masses, morphology, density, margin, contrast enhanced characteristics, location and relationship with adjacent vessels and spaces. Results Among the 52 cases, masses were located in the prestyloid space in 8 cases, in the parotid in 8, within the masticator space in 2, and in the carotid space in 31. In most of the cases, CT revealed the pathologic nature of the masses and adjacent anatomic structure. According to the displacement of the adjacent spaces, muscles and vessels caused by the masses, the origin of the masses could be predicted. The origin of the masses was spatiallyrelated to the internal carotid artery and the jugular vein. Conclusion CT is an effective modality for the positional diagnosis of the masses arising lateral district of neck. Considering the anatomical position and contrast enhanced characteristics and the involvement of the adjacent structure, the qualitative and differential diagnosis can be improved.