小儿颈部淋巴管瘤的MSCT及MRI表现及分析  

MSCT and MRI Manifestation and Analyze of Cervical Lymphangioma in Children

作　　者：林雁捷[1] 郑晓林[2] 王忠[1] 王强[1] 洪晓纯[1] 龚苗苗[1] LIN Yan-jie;ZHENG Xiao-lin;WANG Zhong(Department of Radiology,Dongguan Women and Children Health Hospital,Dongguan 523000,Guangdong Province,China)

机构地区：[1]广东省东莞市妇幼保健院放射科,广东东莞523000 [2]广东省东莞市人民医院放射科,广东东莞523000

出　　处：《中国CT和MRI杂志》2018年第5期43-46,154,共5页Chinese Journal of CT and MRI

摘　　要：目的探讨小儿颈部淋巴管瘤的MSCT及MRI表现特征,旨在提高诊断的准确性。方法回顾性分析32例小儿颈部淋巴管瘤的CT及MRI表现,所有病例均经手术和病理证实。观察和分析病变的部位、累及的间隙、形态、结构、密度/信号及增强等表现。结果病变分别位于颈上、中、下部和颈浅间隙、颈动脉鞘间隙、颈深间隙,其中大部分位于颈中部(共20例)和颈动脉鞘间隙(共21例)。CT及MRI表现为多囊型28例,病变范围较大,形态不规则,内有分隔,沿颈部间隙蔓延;其中16例囊壁和分隔较薄,增强扫描呈轻度强化,囊内容物于CT呈水样密度,于MRI呈长TI、长T2信号。单囊型4例,病变较小,为圆形或类圆形,其中2例壁薄,增强壁轻度强化,囊内容物密度和信号与多囊病变相似。合并感染4例,其中多囊型3例、单囊型1例,囊壁及分隔增厚,周围脂肪间隙模糊,囊内容物密度/信号与肌肉密度相仿,增强囊壁及间隔中度强化。合并出血10例,其中多囊型9例、单囊型1例,CT显示囊内容物密度明显增高,于MRI呈T1及T2混杂信号,可见液液分层。结论 CT及MRI能显示小儿颈部淋巴管瘤的特征性表现,故对明确诊断、制定治疗方案具有重要的价值。Objective To evaluate MSCT and MRI characteristic manifestation of cervical lymphangioma in children so as to promote the diagnostic accuracy. Methods MSCT and MRI manifestations of 32 cases with cervical lymphangioma were analyzed retrospectively and were proved by surgery and pathology. The positions, cervical spaces, structures, densities/signals and enhancement were observed and analyzed. Results The lesions occurred in upper, middle and inferior necks and superficial cervical space, carotid sheath gap and deep cervical space but major lesions were located in carotid sheath gap of middle neck（20 cases and 21 cases respectively）. CT and MRI manifested multi-cysts in 28 cases which had wide ranges and irregular shapes, separated wall in interior, extensioin along cervical space. The cyst walls and separating of 16 cases were thin and were mildly enhanced. Cyst content manifested water-like density in CT, and long-time T1 and T2 signal in MRI. The lesions were single cysts in 4 cases which had less ranges and round or ovate shapes. The cyst walls of 2 cases were thin and were mildly enhanced. The densities and signals of cyst contents were same as multi-cysts. The lesions combined infection in 4 cases（3 cases with multi-cysts,1 case with single cyst） manifested thicken wall and separating with blurred fat space around lesions. The densities/signals of cyst content were same as muscle and cyst walls and separating were moderately enhanced. The lesions combined bleeding in 10 cases（9 cases with multi-cysts, 1 case with single cyst） manifested that cyst contents were higher density in CT and heterogeneous T1/T2 signal in MRI. Liquid-liquid stratifications of cyst contents were seen. Conclusion CT and MRI showed characteristic manifestations of cervical lymphangioma in children and had important values for correct diagnosing and deciding plan of therapy.

关 键 词：小儿颈部病变 淋巴管瘤 CT MR 诊断与分析 

分 类 号：R65[医药卫生—外科学] R73[医药卫生—临床医学]