颈动脉间隙血管移位的方向在颈Ⅱ~Ⅳ区淋巴结源性及神经源性病变中的鉴别价值  

Identification value of vascular displacement direction in carotid space on lymph node-derived and neurogenic lesions in neck Ⅱ-Ⅳ area

作　　者：廖鸿帆 文明[1] 张竹[1] 刘丹[1] 徐婧梅 Liao Hongfan;Wen Ming;Zhang Zhu;Liu Dan;Xu Jingmei(Department of Radiology,The First Affiliated Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《重庆医科大学学报》2020年第10期1410-1413,共4页Journal of Chongqing Medical University

摘　　要：目的:探讨颈动脉间隙血管移位的方向在颈Ⅱ~Ⅳ区淋巴结源性及神经源性病变中的鉴别价值。方法:收集重庆医科大学附属第一医院2017年1月1日至2019年4月15日经病理证实的位于颈Ⅱ~Ⅳ区的淋巴结源性(26例,其中淋巴结结核7例,淋巴结转移8例,淋巴瘤7例,淋巴结炎4例)及神经源性(7例,其中神经鞘瘤6例,神经纤维瘤1例)病变共33例,除了观察病灶大小、边界、形态、密度,强化方式、强化程度等直接征象外,还重点观察颈动脉间隙血管受压移位的方向。结果:2组病灶的大小(Z=-1.456,P=0.145)、边界(χ2=0.480,P=0.652)、形态(χ2=2.257,P=0.190)、密度(χ2=1.451,P=0.378)、强化方式(χ2=1.188,P=0.664)、强化程度(χ2=5.579,P=0.084)均无明显统计学差异;而淋巴结源性病变的颈动脉间隙血管向内移位为26例(100%),神经源性病变的颈动脉间隙血管向外移位6例(85.7%),向内移位1例(14.3%),差异具有统计学意义(χ2=27.238,P=0.000)。结论:颈动脉间隙血管移位的方向可作为颈Ⅱ~Ⅳ区淋巴结源性及神经源性病变的重要鉴别指标。Objective:To investigate the identification value of vascular displacement direction in carotid space on lymph node-derived and neurogenic lesions in neck Ⅱ-Ⅳ area. Methods:A total of 33 patients whose lesions were pathologically confirmed in the neck Ⅱ-Ⅳ area from 1 st January 2017 to 15 th April 2019 were collected, including lymph node-derived lesion(n=26,including seven patients of lymph node tuberculosis,eight patients of lymph node metastasis,seven patients of lymphoma and four patients of lymphnoditis)and neurogenic lesion(n=7,including six patients of schwannoma and one patient of neurofibroma). Besides the obvious signs of lesion size,boundary,shape,density and enhancement ways and degree, the vascular displacement direction received more attention. Results:There were no significant differences in size(Z =-1.456,P =0.145),boundary (χ~2=0.480,P =0.652),shape (χ~2=2.257,P =0.190),density(χ~2=1.451,P=0.378),ways of enhancement(χ~2=1.188,P=0.664),and degree of enhancement (χ~2=5.579,P =0.084) between two groups. In contrast,26 patients(100%) with lymph node lesion had inward displacement,carotid space vascular moving inside,six patients with neurogenic lesion(85.7%) had outward displacement,and one patient with neuro genic lesion(14.3%)had inward displacement, with statistically significant differences(χ~2=27.238,P=0.000). Conclusion:The direction of vascular displacement in carotid space can be used to identify the lesion from lymph node or nerve in the neck Ⅱ-Ⅳ area.

关 键 词：颈部肿块 颈动脉间隙血管 计算机体层摄影术 淋巴结 神经 

分 类 号：R445.3[医药卫生—影像医学与核医学]