颌面颈部血管滤泡性淋巴组织增生的超声诊断分析

Diagnosis of angiofollicular lymphonode hyperplasia in neck and maxilloficial region by ultrasonic examination

目的:分析超声检查对颌面颈部血管滤泡性淋巴组织增生的诊断价值。方法:回顾性总结了32 例经手术和病理证实的血管滤泡性淋巴组织增生的彩色多普勒声像图表现。结果: 32 例术前彩色多普勒检查仅1 例诊断为本病。32 例声像图表现为:单个多见,位于颈中部颈动脉的浅外侧约2 ~ 3 cm 处;椭圆形,外形规则,边界清楚。内部回声为不均匀的低回声。血供极丰富,Ⅳ级占72%。本病需与颈动脉体瘤、血管瘤、淋巴结核及淋巴瘤相鉴别;腺体内血管滤泡性淋巴组织增生还需要与腺体内其他良性肿瘤鉴别(例如腺淋巴瘤)。结论:血管滤泡性淋巴组织增生声像图误诊率高,但有一定特征性表现,可于手术前作出较准确定性定位。

Objective: To evaluate the diagnostic value of ultrosonic examination in the diagnosis of angiofollicular lymphonode hyperplasia( AFH) in neck and maxilloficial region. Methods: The sonographic manifestation of 32 cases of AFH proved by operation and pathology was retrospectively studied. Results: Among the 32 cases only one was diagnosed as AFH by color doppler flow imaging ( CDFI) preoperatively. The sonographic characteristics of AFH were as following: mostly single,located at superficial lateral 2 - 3 cm to carotid artery in middle part of cervico,generally elliptic,regular contour with clearly defined boundaries. The internal echo were homogeneous dim/dull /gloomy pachylight spots. The blood supply was extremely abundant as grade Ⅳ( 72%). Attention should be paid to the differentiation of AFH from carotid body tumor,hemangioma,lymphous tuberculosis and lymphoma. The glands also need to be distinguished from other benign tumors of other glands ( eg. adenolymphoma). Conclusion: AFH may be frequently misdiagnosed by CDFI,but the features of sonograph can give accurate preoperative quantitation and localization and provide credible basis for operative scheme.