颈外侧部囊性肿块的CT诊断及鉴别诊断  

CT Diagnosis and Differential Diagnosis of Cystic Masses in Lateral District of Neck

作　　者：吕晓飞[1] 张雪林[1] 邱迎伟[1] 苏欢欢[1] 

机构地区：[1]南方医科大学附属南方医院影像中心,广州510515

出　　处：《临床放射学杂志》2009年第12期1611-1614,共4页Journal of Clinical Radiology

摘　　要：目的分析颈外侧部囊性肿块的CT表现,探讨该区域囊性病变的CT诊断及鉴别诊断价值。资料与方法回顾性分析43例经手术病理证实的颈外侧部囊性肿块(囊肿20例,肿瘤性病变15例,炎性病变8例)的CT表现,包括病灶的大小、形态、边缘、密度、强化特点、肿块的解剖部位及其与邻近血管和间隙的关系等。结果囊肿、肿瘤及炎性肿块的平均发病年龄分别为20.3岁、49.4岁、33.3岁。66.67%(18/27)单发病变为囊肿,56.25%(9/16)多发病变为肿瘤性病变。肿块位于咽旁间隙10例,颈血管间隙22例,颈后间隙6例,腮腺间隙3例,胸锁乳突肌外侧2例。70%(14/20)囊肿边界清晰壁薄,66.7%(10/15)肿瘤性病变壁厚薄不均,75%(6/8)炎性病变周围可见炎性渗出表现。囊肿囊壁无或轻度强化,多数肿瘤及炎性病变囊壁呈中度或明显强化。结论CT能对颈外侧部囊性肿块准确定位,结合囊性肿块的囊壁、囊内外及CT强化特点有利于定性及鉴别诊断。Objective To investigate CT findings of cystic masses in lateral district of the neck and to study CT diagnosis and differential diagnosis of those cystic lesions. Materials and Methods 43 cases with cystic lesions in lateral district of the neck （20 cystic masses,15 tumor masses,and 8 inflammatory masses） comfired by operation-pathology were analysed.CT finding were retrospectively studied on the size of the masses,morphology,margin,density,contrast enhanced characteristics,location and relationship with adjacent vessels and spaces. Results The mean ages of cyst group, cystic tumor group and inflammatory lesions group were 20.3 years ,49.4 years and 33.3 years respectively. 66.67% （18/27）solitary lesions were cvsts and 56. 25% （9/16） multitude lesions were tumors. The masses were located in the parapharyngeal spaee （n = 10）, carotid space （n = 22 ）, posterior cervical space lesions（n =6）, parotid spaees（n =3）,and cleidomastoidal lateral space（n =2）. 70% （14/20） cysts appeared as well-eireumseribed masses,smooth,and the cystic walls were thin. The wall of 66.7% （10/15） tumor lesions were uneven thickness. inflammatory infiltration in surround structures was seen in 75% （6/8）inflammatory lesions. The wall of cysts were not en- hanced or mildly enhanced,but most tumor and inflammatory lesions were moderately or highly enhanced. Conclusion CT is an effective modality for the positional diagnosis of the masses in lateral district of neck. Considering the features of cystic wall ,inside mad outside the cystic masses and contrast enhanced characteristics,the qualitative and differential carl be improve.

关 键 词：头颈部肿块 囊性病变 体层摄影术 X线计算机 

分 类 号：R653[医药卫生—外科学]