B超、穿刺、CT、MRI检查对潜突型舌下腺囊肿的诊断价值  

The diagnosis value of ultrasonography,puncture,CT and MRI for Plunging Ranula

作　　者：杨宁[1] 

机构地区：[1]秦皇岛市第二医院口腔科,河北秦皇岛066600

出　　处：《口腔医学》2014年第12期943-945,共3页Stomatology

摘　　要：目的探讨B超、穿刺、CT和MRI检查对潜突型舌下腺囊肿的诊断价值。方法 36例颏下/颌下囊性肿物术前应用B超检查,穿刺检查,再行CT或MRI检查以明确嚢肿壁是否来自舌下腺。明确诊断的患者行口内切口摘除患侧舌下腺,不能明确的行颈部探查,术中发现为囊肿内容物为黏液成分后改为口内入路切除舌下腺。术后病理确诊。采用SPSS 13.0软件分析确诊率差异。结果 B超、穿刺、CT及MRI四种方法判断潜突型舌下腺囊肿的确诊率分别为53%、62%、87%和100%。统计分析显示4种检查方法确诊率有显著性差异（P〈0.05）。所有术后病理确诊与术前诊断相符,随访3~36个月不等,未见有患者复发。结论位于颏下/颌下区的囊性肿物可行MRI检查,明确囊肿来源,有助于术前明确诊断,以正确指导手术,避免颏下/颌下区探查手术。尤其对于不能配合穿刺造影检查的儿童患者,MRI检查更有优势。Objective It is difficult to differentiate plunging ranula from thyroglossal duct cysts, lymphangioma and branchial cleft cyst disease, and this paper aims to explore the diagnosis value of ultrasonography, puncture, CT and MRI. Methods Thirty-six cases with the submental or submandibular cystic iesions, were checked preoperatively by manual examination ＆ ultrasonography first, and then puncture examination, CT and MRI partialy. The images clearly showed the cyst wall originated from the ipsilateral sublingual gland and the removal of the ipsilateral sublingual gland was carried out with intraoral approach. As for the patients without correct pre- operative diagnosis exploration operation was performed by transcervical approach. Once the content of the cystic lesions was mucus, the operation converted to sublingual gland removal by intraoral approach. Chi-square test by SPSS 13.0 was used in data analysis. Results The correct diagnosis rate of ultrasonography, puncture, CT and MRI was 53% ,62% ,87% and 100% respectively. The analysis showed that the correct diagnosis rate between the four groups had significant discrepancy by Chi-square test（P 〈 0.05）. After removal of ipsilateral sublingual gland, there was no recurrence in patients with 3 to 36 months follow-up. The postoperative pathology confirmed the preoperative diagnosis. Conclusions The patients with cystic lesions located in the submental and suhmandibular region can carry out MRI examination, which can clearly show the travel and origin sites of cystic lesions. The non-invasive image examination can con- tribute to correct diagnosis preoperatively, which help doctor avoid the submental or submandibular area exploration. It is especially useful for the pediatric patients with poor cooperation during the puncture ＆ angiography examination.

关 键 词：潜突型舌下腺囊肿 诊断 MRI 

分 类 号：R782.051[医药卫生—口腔医学]