协和医学杂志

2014, v.5(03) 312-317

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鳃裂囊肿和鳃裂瘘管的超声成像特征
Sonographic Characteristics of Brachial Cleft Cysts and Brachial Cleft Fistulas

张波;杨筱;姜玉新;李文波;齐振红;谭莉;张璟;杨倩;
ZHANG Bo;YANG Xiao;JIANG Yu-xin;LI Wen-bo;QI Zhen-hong;TAN Li;ZHANG Jing;YANG Qian;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

摘要(Abstract):

目的探讨灰阶超声和彩色多普勒在鳃裂囊肿和鳃裂瘘管诊断中的应用价值。方法回顾性分析北京协和医院2010年1月至2014年1月收治的19例鳃裂囊肿和鳃裂瘘管患者的临床资料及超声图像资料,对照手术及病理结果,分析其超声图像特征。结果鳃裂囊肿共14例,包括第一鳃裂囊肿5例,第二鳃裂囊肿9例;鳃裂瘘管共5例,包括第一鳃裂瘘管1例,第二鳃裂瘘管2例,第三鳃裂瘘管1例,第四鳃裂瘘管1例。13例(92.8%)鳃裂囊肿超声表现为形态规则的圆形、类圆形或椭圆形,仅1例形态不规则;12例(85.7%)边界清晰,2例(14.3%)边界不清;7例(50%)呈无回声,其中2例内部多数点状回声漂浮,挤压时可移动;2例(14.3%)为囊实性;4例(28.6%)为实性不均质低回声;彩色多普勒显示4例(28.6%)周边条状血流,10例(71.4%)未见血流信号。4例(80%)鳃裂瘘管超声表现为条状或不规则低回声,2例(40%)显示瘘管回声;1例(20%)为片状低回声,形状不规则;3例(60%)为实性,2例(40%)为囊实性;彩色多普勒显示2例(40%)内部可见条状血流,1例(20%)边缘条状血流,2例(40%)未见血流信号。结论鳃裂囊肿和鳃裂瘘管具有典型的超声成像特征,可为临床提供不可或缺的诊断信息。
Objective To investigate the value of gray-scale and color Doppler ultrasound in the diagnosis of brachial cleft cysts and brachial cleft fistulas. Methods The sonographic and clinical records of 19 patients with pathologically proven brachial cleft cysts and brachial cleft fistulas between January 2010 and January 2014were retrospectively reviewed and the sonographic characteristics of the brachial cleft abnormalities were analyzed.Results Fourteen cases were diagnosed as brachial cleft cysts( 5 were First,9 were Second),5 cases were diagnosed as brachial cleft fistulas( 1 was First,2 were Second,1 was Third,1 was Fourth). On the ultrasound,the brachial cleft cysts manifested as round or oval in 92. 8%( 13 /14),and 85. 7%( 12 /14) had a sharp border;50. 0%( 7 /14) were echo-free,and floating echo points could be found in 2 of them. Also,14. 3%( 2 /14) had solid cysts with small cystic structure,and 28. 6%( 4 /14) had purely heterogeneous solid cysts. Color Doppler flow imaging( CDFI) showed 28. 6%( 4 /14) were peripherally vascularized and 71. 4%( 10 /14) were not vascularized. In the 5 patients with brachial cleft fistulas,4( 80%) had hypo-echoic strips or irregular shape,2( 40%) showed the fistula,3( 60%) were solid,and 2( 40%) were mixed solid and cyst. CDFI showed2( 40%) were inner-part vascularized,1( 20%) was peripherally vascularized,and 2( 40%) were not vascularized. Conclusion Brachial cleft cysts and brachial cleft fistulas have typical ultasound manifestations,which can guide the preoperative diagnosis of these diseases.

关键词(KeyWords): 鳃裂异常;鳃源瘤;瘘;超声;诊断
brachial cleft abnormality;branchioma;fistula;ultrasound;diagnosis

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作者(Author): 张波;杨筱;姜玉新;李文波;齐振红;谭莉;张璟;杨倩;
ZHANG Bo;YANG Xiao;JIANG Yu-xin;LI Wen-bo;QI Zhen-hong;TAN Li;ZHANG Jing;YANG Qian;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

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