高频超声对甲状舌管囊肿的分型及诊断价值

摘要

Objective To probe the clinical diagnosis value of high frequency ultrasonography (HFUS) in thyroglossal duct cyst(TDC). Methods Forty-one TDC were taken HFUS and the location, boundary,shape,interal echo of lesions and the relation to hyoid bone were observed. The periphery and internal blood flow signal were detected by color Doppler flow imaging. The results of HFUS were compared with those of pathology after operation. The cases were divided into groups according to pathological types and were compared with acoustic image shows. Results All cases were diagnosed TDC by pathology after operation. Internal walls of 9 TDC consist of cilium columnar epithelium, 19 consist of stratified pavement epithelium and 13 consist of this two epitheliums. HFUS showed different pathological types had different ultrasonic appearances. In this study, 77.8%(7/9) TDC with columnar epithelium showed echoless,84.2 (16/19) TDC with pavement epithelium showed similar solid echopattern and TDC with two epitheliums mainly showed similar solid echopattern and multi-room cyst. Hyperechogenicity of hyoid bone displayed around the lesion in 80.5%(33/41)TDC. No blood flow signal showed in 41 TDC and a little punctiform blood flow signal showed in the periphery of 5 TDC. The diagnose accordance rate of HFUS in TDC was 95.1%(39/41). Conclusions HFUS can clearly show the location, boundary, shape,interal echo of TDC and its relation to hyoid bone. HFUS is important for diagnosis and differential diagnosis of TDC.%目的 探讨高频超声检查对甲状舌管囊肿(TDC)的临床诊断价值.方法 应用高频超声检查41例TDC,观察病变的位置、边界、形态、内部回声及其与舌骨的关系,并应用彩色多普勒血流显像观察肿物边缘与内部的血流信号.超声检查结果 与手术病理诊断对照,将所有资料按照病理类型分组并分别与声像图表现对比.结果 全部病例均经手术病理证实为TDC,其中9例TDC内衬纤毛柱状上皮,19例内衬复层鳞状上皮,另13例TDC为两种上皮共同存在.高频超声检查显示不同病理类型的TDC超声表现不同,本组77.8%(7/9)内衬柱状上皮的TDC内部表现为无回声,而84.2%(16/19)内衬鳞状上皮的TDC为类实性回声,两种上皮并存的TDC则多表现为类实性和多房囊肿回声类型(P<0.01).本组资料同时显示80.5%(33/41)TDC病变周围可测及清晰的舌骨强回声,41例TDC内部均未见明显血流信号,仅于5例病变囊壁边缘见少许点状血流信号.高频超声检查对TDC的诊断符合率高达95.1%(39/41).结论 高频超声检查能清晰显示肿物的位置、边界、形态、内部回声及其与舌骨的关系,对TDC的诊断和鉴别诊断有重要作用.