5种检查方法在颈部舌下腺囊肿诊断中的评价

The Evaluation of 5 Check-up Methods to Diagnose Ranula in the Neck.

目的 :评价 5种检查方法在诊断颈部舌下腺囊肿中的作用。方法 :检查方法包括手法检查、B超、穿刺、淀粉酶检查、囊腔造影 +CT。以术中确定囊腔与舌下腺相连为最终诊断。记录每种检查方法误诊、误导发生率 ,客观评价各种检查的优缺点。结果 :突入颈部的舌下腺囊肿确诊率为 5 8.3% ,误诊率为 4 1.7%。在各项检查中 ,囊腔造影 +CT误诊率为 0 ,手法检查误诊率为 2 5 % ,B超占 2 0 % ,检查手段不全占 18.8% ,淀粉酶假阳性占 16 .7%。经 χ2 检验各检查的误诊率有显著性差异 (χ2 =19.36 ,γ =8,P <0 .0 5 )。不同检查结果的汇集会影响误诊率。结论 :在各单项检查中 ,囊腔造影 +CT误诊率最低 ,其它各项均有 2 5 % 16 .7%的误诊率 ,优选诊断步骤是手法检查→穿刺→造影 +CT。

Objective:To evaluate the effects of 5 check-up methods which diagnose ranula in the neck.Methods:These methods included check-up by hands, ultrasound B, puncture, amylase test and cyst radiography + CT.The final diagnosis was made by finding the connection between the cyst and sublingual gland during operation.The rates of misdiagnosis and misleading of each check-up were recorded.The advantages and disadvantages of each method were objectively evaluated.Results:The rate of correct diagnosis of cervical plunging ranula was 58.3%,and the misdiagnostic rate 41.7%.Of all check-ups the misdiagnostic rate of cyst- radiography was zero,check-up by hands 25%,ultrasound B 20%,lacking check-ups 18.8%,amylase test 16.7%.By Chi-square test there were significantly difference among different methods (χ 2=19.36, γ=8, P <0.05).The collection of different results could influence on the maldiagnostic rate.Conclusions:Among these checkups,there was the lowest misdiagnostic rate for cyst -radiography.The others had misdiagnostic rate between 25%~16.7%.The proper diagnostic steps should be as follows: check-up by hands →puncture→cyst- radiography+CT.