小儿颈部肿物的超声诊断分析

The analysis of sonographic manifestations in children with neck masses

目的:探讨小儿常见颈部肿物的病理类型、生长特点与超声声像图特征。方法:选取2019年1月—2020年12月于广州市妇女儿童医疗中心就诊的170例颈部肿物患儿,结合其临床资料(年龄、性别)、病理结果及术后诊断情况进行回顾性分析,分析小儿颈部肿物的常见病理类型、超声诊断准确率,总结不同年龄段常见颈部肿物的超声声像图特征,并对误诊病例进行分析。结果:小儿颈部肿物的常见病理类型按照发病率由高到低分别是鳃裂畸形(43.5%)、淋巴管畸形(29.4%)、毛母质瘤(7.6%)、甲状舌管囊肿(5.9%)。淋巴管畸形和先天性梨状窝瘘好发于新生儿期,鳃裂畸形在婴幼儿期和儿童期的发生率最高。先天性梨状窝瘘和毛母质瘤的超声诊断准确率达100.0%;淋巴管畸形和鳃裂畸形的超声诊断准确率分别为93.5%和90.1%;超声诊断甲状舌管囊肿的准确率为75.0%。结论:鳃裂畸形和淋巴管畸形是最常见的小儿颈部肿物。超声诊断大部分不同年龄段小儿颈部肿物的准确率高,为合理的临床决策提供客观的科学依据。

Objective To investigate the pathological types,growth features and ultrasonic traits of the common cervical masses in children.Methods 170 children with cervical masses who were treated in Guangzhou women and children's medical center from January 2019 to December 2020 were selected,to make a retrospective analysis based on their clinical data(age,sex),pathological results and postoperative diagnosis.The common pathological types of children's cervical masses and the accuracy of ultrasonic diagnosis and the misdiagnosed cases were analyzed.The ultrasonic image characteristics of common cervical masses at different ages was summarized.Results According to the incidence rate,the common pathological types of cervical masses in pediatric population were branchial anomalies(43.5%),Lymphatic malformation(LM,29.4%),pilomatricoma(PM,7.6%),and thyroglossal anomalies(5.9%).In the neonatal period,LM and congenital pyriform sinus fistula(CPSF)were common cervical masses,while branchial anomalies in infancy and childhood was the most.Moreover,CPSF and PM both had highest ultrasound diagnostic accuracy of 100.0%,followed by LM and branchial anomalies of 93.5%and 90.1%respectively,the accuracy of ultrasonic diagnosis of thyroglossal duct cyst was 75.0%.Conclusion Branchial anomalies and LM are the most common cervical masses in children.Ultrasound enables a high diagnostic accuracy of cervical masses in most children with different ages,carrying a lot of weight with clinical decision.