颈部肿块CT的诊断(附21例分析)

CT diagnosis of cervial mass (analysis of 21 cases)

目的:探讨CT对颈部肿块定位、定性的诊断价值。方法:回顾分析21例经手术及病理证实的颈部肿块病变21例,包括颈部淋巴结结核10例,神经元性肿瘤6例,淋巴管瘤3例,脂肪瘤2例。结果:①颈部淋巴结结核最常见,占47·6%(10例),典型表现为结节状环形周边强化,相互融合呈花环状;②神经纤维瘤好发于椎旁三角区,实性肿块呈不均匀强化。颈动脉体瘤好发于颈动脉分叉水平,肿块明显强化。神经鞘瘤表现为形态规则、边界清楚的等密度肿块,呈中等程度强化。神经纤维肉瘤肿块密度不均,边界不清,无特征性改变;③淋巴管瘤好发于颈部的疏松间隙,CT常为薄壁囊性肿块,囊壁及内部分隔可见强化;④脂肪瘤表现为典型的脂肪密度,无强化。结论:CT强化扫描有助于颈部肿块的定位、定性诊断。

Objective： To explore the localized and quatitative diagnostic value of CT cervical lump. Methods：21 cervical lump cases, which were confirmed by operation and pathological test, were analyzed retrospectively. Among these 21cases, 10 cases were cervical lymph node tuberculosis, 6 cases were ganglion tumor, 3 cases were lymph node vessel tumor, and 2 cases were lipoma. Results：（1） Cervical lymphoglandular tubereulosis was the most common disease, which was aceount for 47.6% （10 eases）. Typical manifestation was loops with nodes and peripheries were intensified; mutual fused and displayed as floral loops; （2） Neurological fibroma often occurred in vertebral side trianglar area, solid lump which was intensified unevenly. Carotid body tumor often occurred in the level of carotid crotch, and the lump was clearly intensified. Neurilemoma often manifested regular shape and distinct boundary equally-density lump, which was intensified obviously. The density of fibrosareoma was non-uniform, unelearly boundary and no characteristic change; （3） Lymphatic vessel tumor often occurred in cervical rarefaction interstitials, which manifested itself thin-wall cystic in CT, and cystic wall and internal division could be seen intensified; （4）Lipoma represented typical lipid density, there was no intensification. Conclusion：CT intensified scan can be helpful in the localized and qualitative cervical lump.