高频超声诊断颈部肿块的临床价值

Clinical value of high frequency ultrasound in diagnosis of neck masses

目的探讨高频超声在颈部肿块诊断中的临床价值。方法利用高频超声对280例颈部包块患者进行检查,详细记录肿块位置、大小、形态、包膜、边界、内部回声、有无钙化、有无液化、血供情况以及毗邻关系等。280例患者中226例行超声引导经皮穿刺组织活检,54例行局部切口组织活检或手术切除组织病理检查。结果 280例患者经高频超声诊断,病变位于颈前正中3例、左侧颈部95例、右侧颈部80例、两侧颈部102例;肿块好发部位依次为颌下(176例)、颈侧部(260例)、锁骨上窝(134例)、颈前正中(4例)。肿块按内部回声性质分为实质型(98例)、混合型(120例)、囊型(41例)和钙化型(21例);按回声强度分为强回声型(62例)、不均质型(49例)、低回声型(125例)、等回声型(44例)。病理结果证实,260例为颈部良性包块,20例为颈部恶性包块。结论高频超声对颈部肿块良、恶性的鉴别有重要临床价值。

Objective To discuss the clinical value of high frequency ultrasound in the diagnosis of neck masses. Meth- ods 280 cases of neck masses were examined by high frequency ultrasound to record the mass location, size, shape, envelope, borders, internal echo, with or without calcification, with or without liquidation, blood supply and adjacent relation in detail. A- mong 280 cases, 226 cases were performed the biopsy by ultrasound-guided percutaneous puncture, and the other 54 cases under- went biopsy by local incisions or histopathology examination by surgical resection. Results 280 cases were diagnosed by high fre- quency ultrasound. The lesion locations were 3 cases of anterior neck middle, 95 cases of left neck, 80 cases of fight neck and 102 of bilateral neck;the predilection sites of masses were successively submaxilla （176 cases）,lateral neck （260 cases）, supra clavicular fossa （ 134 cases） and anterior neck middle （4 cases） ;according to the internal echo natures, masses were divided into the parenchymal type （98 cases ）, mixed type （ 120 cases）, cyst type （41 cases） and calcification type （21 cases） ; according to the echo intensities, masses were divided into the strong echo type （62 cases）, heterogeneity type （49 cases）, low echo type （125 cas- es） and isoecho type （44 cases）. The results of the pathological examination verified 260 cases of benign neck mass and 20 cases of malignant neck mass. Conclusion High-frequency ultrasound has important clinical value in differentiating benign and ma- lignant neck masses.