目的:讨论术前超声(US)的影像学表现和实用性,对比增强计算机断层扫描(CE-CT)和对比增强磁共振成像(CE-MRI)诊断小儿头颈部淋巴畸形(HNLM)。
方法:我们对过去9年转诊到我院治疗HNLM的170名儿童进行了回顾性研究。
结果:US的诊断率,CE-CT和CE-MRI分别为93.0%(146/157),94.7%(143/151)和100%(45/45),分别。就像多房病例一样,囊内间隔的检出率为91.5%(130/142),50.4%(68/135)和88.1%(37/42),差异有统计学意义(χ2=25.8131,p<0.05)。美国在51.0%(80/157)的病例中显示胶囊内容物无回声,49.0%(77/157)的低回声或混合回声,36.9%(58/157)的病例有絮状或点状回声漂浮。CT显示,69.5%(105/151)的胶囊内容物密度低,无增强,30.4%(46/151)的混合密度增强。8.6%(13/151)的病例见液液杠杆。MRI显示包膜内容物T1WI高信号和T2WI低信号,28.9%(13/45)例无增强,71.1%(32/45)例混合密度无增强。46.7%(21/45)的病例见液液杠杆。单纯HNLMs与囊内出血的包膜含量差异有统计学意义(回声,密度,信号),增强,和液-液杠杆(所有p<0.05)。在美国,CE-CT和CE-MRI,囊内出血诊断准确率有统计学差异(χ2=25.4152,p<0.05)。
结论:对于HNLM的临床诊断和评估,我们建议US联合CE-CT治疗急性病例,对于稳定的病例,美国联合CE-MRI。
To discuss the imaging manifestations and the utility of preoperative ultrasonography (
US), contrast-enhanced computed tomography (CE-CT) and contrast enhanced magnetic resonance imaging (CE-MRI) in diagnosing the pediatric head and neck lymphatic malformations (HNLMs).
We performed a retrospective review of 170 children who were referred to our hospital in the past 9 years for the treatment of HNLMs.
The diagnostic rates of
US, CE-CT and CE-MRI were 93.0% (146/157), 94.7% (143/151) and 100% (45/45), respectively. As in multilocular cases, intracystic septa detection rate was 91.5% (130/142), 50.4% (68/135) and 88.1% (37/42), and which had a statistical difference (χ2 = 25.8131, p < 0.05).
US showed capsule contents anechoic in 51.0% (80/157) cases, hypoechoic or mixed echoic in 49.0% (77/157) cases, and flocculent or dotted echo floating in 36.9% (58/157) cases. CT showed low density of the capsule contents without enhancement in 69.5% (105/151) cases and mixed density with enhancement in 30.4% (46/151) cases. Liquid-liquid levers were seen in 8.6% (13/151) cases. MRI showed T1WI high signal and T2WI low signal of the capsule contents without enhancement in 28.9% (13/45) cases and mixed density in 71.1% (32/45) cases. Liquid-liquid levers were seen in 46.7% (21/45) cases. There were statistically significant differences between pure HNLMs and intracystic hemorrhage in capsule content (echo, density, signal), enhancement, and liquid-liquid lever (all p < 0.05). Among
US, CE-CT and CE-MRI, intracystic hemorrhage diagnostic accuracy had a statistical difference (χ2 = 25.4152, p < 0.05).
For clinical diagnosis and evaluation of HNLMs, we suggest that US combined with CE-CT for acute cases, and for stable cases,
US combined with CE-MRI.