头颈部淋巴管畸形的CT诊断价值
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上海市儿童医院 上海交通大学医学院附属儿童医院

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上海申康医院发展中心市级医院临床研究培育项目(SHDC12019X21)


CT diagnostic value of head and neck lymphatic malformation
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    摘要:

    目的 探讨儿童头颈部淋巴管畸形(lymphatic malformation,LM)的CT表现及诊断价值。方法 回顾性分析我科2016~2021年57例经手术及病理证实的头颈部淋巴管瘤的CT资料。结果 2岁以内41例(约占71.9%),病灶位于左侧26例,右侧26例,双侧5例;位于颈部、咽旁26例,头面部8例,跨越头面、颈或纵隔23例。临床表现无痛性肿块53例(约占93%),面容改变25例,喉喘鸣、呼吸困难或吞咽困难7例,上述临床表现可单独或者同时出现。单房型25例,多房型32例;瘤内合并出血者30例;55例CT诊断LM,阳性率96.5%。CT可表现单房或多房,呈圆形、不规则形及分叶状低密度或等密度影,沿着组织间隙呈现爬行性生长,边界清楚或不清,部分病例可见分隔影,增强后囊内容物不强化,纤维状分隔及囊壁呈点状、条状、条索状及网格状强化。合并感染或出血时CT值升高,部分病例可见液-液平面。结论 CT检查能清晰显示头颈部LM的位置、大小及累及范围,且具有一定的特征性表现,对LM的诊断和制定治疗方案具有重要价值。

    Abstract:

    Objective To investigate the CT findings and diagnostic value of head and neck lymphatic malformation in children. Methods The CT data of 57 cases of head and neck lymphatic malformations confirmed by surgery and pathology from 2016 to 2021 were analyzed retrospectively. Results 41 cases (about 72%) were under 2 years old. The lesions were located on the left in 26 cases, on the right in 26 cases and on both sides in 5 cases; The lesions were located in the neck and parapharyngeal in 26 cases, in the head and face in 8 cases, and across the head, neck or mediastinum in 23 cases. The clinical manifestations were painless mass in 53 cases (about 93%), facial changes in 25 cases, laryngeal wheezing, dyspnea or dysphagia in 7 cases. The above symptoms could occur alone or at the same time. There were 25 cases of single chamber type and 32 cases of multi chamber type; There were 30 cases of intratumoral hemorrhage; 55 cases of CT diagnosis of lymphatic malformation, the positive rate was 96.5%. CT can show single chamber or multi chamber, round, irregular and lobulated low-density or equal density shadow, creeping growth along the tissue gap, clear or unclear boundary, separation shadow can be seen in the capsule, the contents of the capsule are not strengthened after enhancement, and fibrous separation and capsule wall are strengthened in point, strip, cord and grid shape. When combined with infection or bleeding, the CT value increased, and the liquid-liquid level could be seen at the same time. Conclusions CT examination can clearly show the location, size and range of head and neck lymphatic malformation, and has certain characteristic manifestations, which is of great value for diagnosis and treatment.

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  • 收稿日期:2022-04-13
  • 最后修改日期:2022-05-18
  • 录用日期:2022-05-24
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