甲状舌骨囊肿的高频超声分型表现  

Classification of thyroglossal duct cyst by high-frequency ultrasound

作　　者：左恒玲[1] 赵新宇 姜辉 郭照萌 杨育煌 骆冬梅 李胜 王鹏 ZUO Heng-ling;ZHAO Xin-yu;JIANG Hui;GUO Zhao-meng;YANG Yu-huang;LUO Dong-mei;LI Sheng;WANG Peng(Department of Ultrasound, Longgang Central Hospital, Shenzhen 518116, Guangdong, China;Department of Ultrasound, Longgang NET Hospital, Shenzhen 518172, Guangdong, China)

机构地区：[1]深圳市龙岗中心医院超声科,广东深圳518116 [2]深圳市龙岗区耳鼻咽喉医院,广东深圳518172

出　　处：《生物医学工程与临床》2019年第3期280-284,共5页Biomedical Engineering and Clinical Medicine

基　　金：深圳市龙岗区科技创新委基础研究项目(LGKCYLWS2018000226)

摘　　要：目的探讨甲状舌骨囊肿(TGDC)的高频超声声像图分型特征及检查方法,为TGDC的诊治提供影像学信息。方法选择经手术并病理诊断的92例TGDC患者,其中男性35例,女性57例;年龄3～65岁,中位年龄29.5岁。分析其超声声像图特征,观察肿物的大小、形状、边缘、内部与后方回声,以及相对于中线的位置、纵向延伸到舌根的存在、与舌骨、胸骨舌骨肌等毗邻关系及血液供应情况。结果单发病灶90例(97.83%),多发病灶2例(2.17%);最大者约69 mm×53 mm×37 mm,最小者约9 mm×5 mm×4 mm。类卵圆形或者梭状65例(70.65%),呈不规则分叶状27例(29.35%);无并发炎症的病灶边界清晰,有完整包膜77例(83.70%);伴有炎症的病灶与周围组织边界不清,无法分辨包膜的边界15例(16.30%);其中相对于中线偏左侧位置49例(53.26%),相对于中线位置20例(21.74%),相对于中线偏右侧位置23例(25.00%);位于舌骨水平上方31例(33.70%),位于舌骨水平下方61例(66.30%),与舌骨关系密切者69例(75.00%);病变位于胸骨舌骨肌的深方66例(71.74%),位于胸骨舌骨肌的浅方26例(28.26%),纵向延伸到舌根59例(64.13%),观察病灶分隔内中等实质性回声区血管可探及低速动静脉中等阻力指数的动脉频谱。Ⅰ型TGDC 43例,占患者46.74%(43/92);Ⅱ型TGDC 30例,占患者32.61%(30/92);Ⅲ型TGDC 19例,占患者20.65%(19/92)。所有的TGDC患者的病理显微镜检查显示标本内见有甲状腺滤泡上皮细胞,超声诊断与病理诊断符合率为87%。其中Ⅰ型、Ⅱ型、Ⅲ型TGDC超声分型与病理诊断符合率分别为93%、77%和48%。结论高频超声清晰地显示TGDC的毗邻关系与声像图特征,可以作为TGDC术前分型的首选无创性检查方法,提高临床诊断率,值得临床推广应用。Objective To investigate features of high-frequency ultrasound sonographic and examination methods of thyroglossal duct cyst(TGDC), and provide imaging information for diagnosis and treatment of TGDC. Methods A total of 92 TGDC patients confirmed by operation and pathology were retrospectively enrolled, which included 35 males and 57 females, aged 3-65 years old with median age of 29.5 years old. The characteristics of ultrasound sonogram were analyzed. The size, shape,edge, internal and posterior echoes of tumor, and position relative to midline, longitudinal extension to tongue base, the adjacent relationship with hyoid bone, the sternum and sternohyoid muscle, and blood supply were observed. Results Of 92 cases, single lesion were found in 90(97.83 %) and multiple lesions in 2(2.17 %), the largest tumor was 69 mm x 53 mm x 37 mm and the smallest was 9 mm x 5 mm x 4 mm. Sixty-five cases(70.65 %) were ovoid or spindle-like, 27 cases(29.35 %) of lobulated. Seventy-seven cases(83.70 %) without inflammation were well-defined and complete capsule, 15 cases(16.30 %) with inflammatory lesions and surrounding tissue were unclear, and boundary of capsule was no resolved. Relative to the midline position, 49 cases(53.26 %) were on the left side, 23 cases(25.00 %) on the right and 20 cases(21.74 %) located in the middle line. Thirty-one cases(33.70 %) located above hyoid bone and 61 cases(66.30%) below hyoid bone, 69 cases(75.00%) were closely related to hyoid bone. Sixty-six(71.74 %) located in the deep of sternohyoid muscle, 26 cases(28.26 %) were in superficial side, 59 cases(64.13 %) longitudinally extended to tongue base. The arterial spectrum of medium-synchronous echo in lesion separation and the low-speed arteriovenous resistance index showed that 43 cases(46.74 %) of type I TGDC, 30 cases(32.61 %)of type II TGDC and 19 cases(20.65 %) of type Ⅲ. The pathological diagnosis of TGDC patients showed thyroid follicular epithelial cells, the coincidence rate between ultrasound diagnosis and pathological diagnosis was

关 键 词：甲状软骨 毗邻关系 甲状舌骨囊肿 解剖 高频超声 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R767.3[医药卫生—诊断学]