小儿甲状舌骨囊肿、甲状舌骨瘘超声表现

摘要

Objective To analyze the ultrasonographic appearance of thyroglossal duct cysts and thyroglossal duct ifstula, and disicuss the value of ultrasonography in the diagnosis of thyroglossal duct cysts and thyroglossal duct ifstula. Methods Totally 142 cases of surgically and pathologically conifrmed thyroglossal duct cysts and thyroglossal duct ifstula cases in Beijing Children′s Hospital Afifliated to Capital Medical University from 2005 to 2012 were retrospectively reviewed and the ultrasonographic characteristics were analyzed. Results Among 142 cases, 128 cases of thyroglossal duct cyst were diagnosed by ultrasound. The ultrasonographic manifestation generally presented as anechoic and uneven medium echo cystic masses, with posteria wall echo enhancement. Most of the cyst walls were thin, and close to the thyoid, with or without deep ifstula. If the cysts were associated with infection, the wall would be thickening and echo enhancement of the surrounding soft tissue could be seen. Cysts ranged from the root of tongue to the suprasternal fossa, mostly in midline level of the neck. Of all the 128 cases, 95 cases were single cyst, round in shape; 33 cases had irregular shape with a fistula extended deeply, 13 cysts extended to the hyoid trailing edge, 20 cases extended to the mouth lfoor. Ultrasound examination revealed ifstulas in 10 cases, which presented as a hypoechoic thin strip-like echo inside the neck soft tissue, 6 cases extended to the hyoid bone direction, 2 cases extended to the mouthlfoor, 2 cases extended to the front thyroid. The other 4 cases showed anterior hypoechoic area, without cyst or ifstula structure. Conclusions Ultrasound is valuable in detcting the size, position, internal echo of the cyst and sinus, as well as showing their relationship with the hyoid. It is an optimal choice for the diagnosis of thyroglossal cyst and thyroglossal ifstula.%目的：总结小儿甲状舌骨囊肿、甲状舌骨瘘超声表现，探讨超声检查对小儿甲状舌骨囊肿、甲状舌骨瘘的诊断价值。方法回顾性分析北京儿童医院2005-2012年收治的142例经手术及病理证实的甲状舌骨囊肿及甲状舌骨瘘患儿，总结其超声声像图特点。结果本组142例患儿，超声诊断为甲状舌骨囊肿128例。超声表现为颈前无回声或回声不均匀的细密中等回声囊性包块，后壁回声增强，囊壁大多数较薄，与舌骨关系密切，伴或不伴有深方的窦道，如囊肿伴有感染，囊壁增厚，周围软组织回声增强；囊肿范围从舌根至胸骨上窝，大部分位于颈中线水平。95例超声表现为单一囊肿，呈类圆形；33例囊肿形态不规则并伴有向深方延伸的窦道，其中13例向舌骨后缘延伸，20例向口底方向延伸；超声检查发现瘘道10例，表现为颈部软组织内细条状低回声，其中6例向舌骨方向延伸，2例向口底延伸，2例延伸至甲状腺前方。另外4例表现为颈前低回声区，无囊腔或瘘道结构，分别为小囊肿及瘘道感染后改变。结论超声检查可清晰显示囊肿及窦道大小、位置、内部回声及与舌骨关系，是诊断小儿甲状舌骨囊肿、甲状舌骨瘘首选方法。