Madelung综合征累及头颈部的CT诊断  

CT Diagnosis of Madelung syndrome involving head and neck

作　　者：李仰康[1] 郑瑜[2] 林建浜[1] 蔡爱群[1] 周修国[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院放射科,广东515041 [2]汕头大学医学院附属肿瘤医院药学部,广东515041

出　　处：《放射学实践》2014年第4期390-392,共3页Radiologic Practice

摘　　要：目的:探讨CT对Madelung综合征累及头颈部的诊断价值。方法:回顾性分析24例Madelung综合征累及头颈部患者的CT表现,全部病例均行CT平扫,15例行增强扫描,18例采用2D多平面重组(MPR)和3D容积再现(VR)技术进行图像后处理。结果:24例均显示脂肪组织对称分布,无包膜,边界不清。男性患者病变主要分布于下枕部、后颈部及上背部皮下间隙、胸锁乳突肌及斜方肌深面、椎旁肌间隙、颈前区、腮腺区、面颊部、颈后三角区和锁骨上区;女性患者病变主要累及后颈部皮下间隙。部分病例见肌肉、腺体、大血管、上气道和消化道受压。此外,CT扫描发现头颈部偶发病变5例,包括会厌癌、真菌性上颌窦炎、枕大池蛛网膜囊肿、腮腺Warthin瘤和锁骨上血管畸形各1例。结论:CT是评价Madelung综合征累及头颈部的有效手段,结合2D MPR和3DVR重组技术,可准确显示脂肪组织的分布情况,病灶与肌肉、腺体和大血管的关系以及上气道和消化道受压的程度等,同时可发现头颈部其它偶发病变,对本病的诊断和治疗具有重要价值。Objective：To study the value of CT for the diagnosis of Madelung syndrome involving head and neck. Methods：CT findings of 24 cases with Madelung syndrome involving head and neck were analyzed retrospectively. All cases underwent CT plain scan. Contrast enhanced CT scan was performed in 15 cases,2D multiplanar reformation （MPR） and 3D volume rendering （VR） reformation were performed in 18 cases. Results：All cases showed lesions symmetrically distri- buted, non-encapsulated and ill-defined. In male patients, massive fatty tissue mainly distributed in the subcutaneous space of lower occipital region,posterior part of neck and upper part of back, under the sternomastoid and trapezius muscles, space between paraspinal muscles, and in the anterior region of neck, parotid region, cheek, posterior cervical triangle and supracla- vicular fossa. In female patients,massive fatty tissue was mainly found in the subcutaneous space of posterior part of neck. Compression and deformation of muscle,gland,major blood vessels and upper aerodigestive tract were detected in some ca ses. 5 associated incidental lesions were revealed on CT,including epiglottic carcinoma, fungal maxillary sinusitis, arachnoid cyst of cistern magna,Warthinfs tumor of the parotid gland and supraclavicular vessel malformation for I ease each. Conelu- sion：Madelung syndrome involving head and neck could be effectively evaluated by CT, using 2D MPR and 3D VR tech- niques simultaneously,CT can accurately depict the distribution of fat,relationship between fatty lesion and adjacent muscle,gland or major blood vessels, degree of compression of upper aerodigestive tract, and accompanied incidental lesions. CT provides important value in the diagnosis and treatment of this disease.

关 键 词：体层摄影术 X线计算机 脂肪瘤样病 头颈部病变 诊断 

分 类 号：R816.1[医药卫生—放射医学]