颈部囊性病变的CT、MRI诊断

目的：分析颈部囊性病变的CT、MRI表现，提高对颈部囊性病变的诊断和鉴别诊断能力。资料与方法：回顾分析经手术病理证实的颈部囊性病变16例，其中鳃裂囊肿9例（男8例，女1例，年龄13－62岁，平均28．1岁），甲状舌管囊肿3例（男2例，女1例，年龄4－41岁，平均16．7岁），淋巴管囊肿4例（均为男性，年龄9－56岁，平均33．3岁）。全部均行层厚、间隔5mm的CT薄层平扫，其中6例行增强扫描，5例行MRI轴位、矢状位及冠状位扫描，T1WI用SE序列，T2WI用FSE序列。结果：9例鳃裂囊肿和4例淋巴管囊肿均位于颈侧，前者与胸锁乳突肌紧邻，有的甚至造成了胸锁乳突肌的肥大。3例甲状舌管囊肿位于颈正中线舌骨上下区。形态多呈圆形、卵圆形或梭形，淋巴管囊肿呈分叶状不规则形。以低密度和长T1、长T2信号为主，合并感染、手术或穿刺可使病变密度或信号变得复杂。结论：CT、MRI检查可提高颈部囊性病变的诊断准确性，尤其是MRI可多轴位显示病变的形态及周围关系。

Diagnosis of CT and MRI of the cystic lesions at the neck

Objective:To analyse the findings of the CT and MRI in patients with cystic lesions of the neck in order to improve the ability of the diagnosis and differential diagnosis.Materials and Methods:The CT and MRI findings of sixteen cases of the cystic lesions at the neck were retrospective reviewed.Nine branchial cleft cysts(male 8,female 1,age ranged from 13 to 62 years old,mean 28 1 years),three thyroglossal duct cysts(male 2,female 1,age ranged from 4 to 41 years old,mean 16 7 years),and four lymphangioma (all male,age ranged from 9 to 56 years old,mean 33 3 years).Results:Nine branchial cleft cysts and four lymphangioma occur at the lateral of the neck,and branchial cleft cysts commonly occurs along the lateral border and anterior to sternocleidmastoid muscle.Some leaded to the hypertrophy of the sternocleidmastoid muscle.Three thyroglossal duct cysts occured along the midline of the neck and directly related to the ossa hyoideum.All cases of the branchial cleft cysts and the thyroglossal duct cysts appeared as a round or oval shape.The lymphangioma appeared as lobulated and irregular shape.These cysts showed particular low density and long T1 and long T2 abnormal signal intensity,but these cysts should become complex when accompanied by infection,operation or puncture.Conclusion:CT and MRI can improve the accuracy in the diagnosis of cystic lesions in the neck.