颈部囊性病变的超声诊断价值

EVALUATION OF ULTRASONOGRAPHY IN THE DIAGNOSIS OF CYSTIC LESIONS OF NECK

目的探讨二维和彩色多普勒超声对颈部囊性病变的诊断和鉴别诊断价值。方法回顾性分析88例经临床和病理证实的颈部囊性病变病人的二维及彩色多普勒血流显像表现,总结其超声特点,并与病理诊断结果对照。结果88例颈部囊性病变中,甲状舌管囊肿38例(43.2%),鳃裂囊肿15例(17.0%),颈淋巴管瘤10例(11.4%),颈部淋巴结囊性病变25例(28.4%)。颈部囊性病变各有其好发部位,且病变具有一定的超声特征。甲状舌管囊肿多见于颈中线附近、舌骨上下;鳃裂囊肿多见于中上侧颈部;淋巴管瘤多见于颈侧部、锁骨上,范围较广;部分淋巴结囊性病变,如淋巴结结核、颈淋巴结囊性转移瘤常多发,分布范围较广。甲状舌管囊肿及鳃裂囊肿呈单房性,淋巴管瘤多为多房性,颈淋巴结囊性转移瘤伴有壁结节。结论超声检查对颈部囊性病变具有重要的诊断和鉴别诊断价值。

Objective To assess the value of ultrasonography in the diagnosis and differential diagnosis of cystic lesions of the neck. Methods 2-D and color Doppler sonographic features of the cystic lesions （n= 88） confirmed pathologically or clinically were retrospectively analyzed. Results Thyroglossal duct cyst comprised 43.2% （38/88）, branchial cleft cyst 17.0% （15/ 88）. lymphangioma 11.4% （10/88）, and cystic lymph node of neck 28.4% （25/88）. Each kind of the lesions had its predilection site and ultrasonic features. Most of the thyroglossal duct cyst were found closing to median line and hyoid bone; branchial cleft cyst usually located at upper or middle part of the neck; lymphangioma in lateral part or above the clavicle, and extended widely. Some eystic diseases of lymph node, such as lymphoid tuberculosis, and cystic metastasis of cervical lymph nodes, usually appeared as multiple and wide distribution. Most of the thyroglossal duct cyst and branchial cleft cyst were monolocular, while lymphangioma multilocular. Metastatic tumors of the cystic lymph nodes were always associated with wall nodule. Conclusion Ultrasonography is accurate and reliable in the diagnosis and differential diagnosis of cervical cystic lesions.