鳃裂囊肿和瘘管彩色多普勒超声检查误诊原因探讨

鳃裂囊肿和瘘管彩色多普勒超声检查误诊原因探讨
张云山;邱璇;李进让;刘秋颖;杨克;余泽辉;付万袭
【期刊名称】《临床误诊误治》
【年(卷),期】2014(000)008
【摘要】目的：总结鳃裂囊肿和瘘管的彩色多普勒超声声像图特征,以减少误诊。

方法回顾性分析我院经手术病理检查证实为鳃裂囊肿和瘘管17例的彩色多普勒超声声像图表现,并与手术病理检查结果进行对比分析。

结果本组17例,12例以外耳道下方或颈侧肿块就诊,5例体检发现腮腺和甲状腺内结节就诊。

我院和外院术前
彩色多普勒超声检查,7例确诊鳃裂囊肿或瘘管,10例误诊,误诊率58.8%,误诊为腮
腺实性肿物及颈部淋巴结炎伴液化各3例,甲状腺结节2例,腮腺囊肿及甲状舌管囊肿各1例。

17例均行手术治疗,术后病理检查证实为鳃裂囊肿11例,鳃裂瘘管6例。

术前彩色多普勒超声检查结果与术后病理诊断结果符合率41.2%(7/17)。

结论临床虽然可根据彩色多普勒超声声像图特点及临床表现对鳃裂囊肿和瘘管做出诊断,但
由于受各种因素影响易误诊,应注意与其他颈部囊性占位性病变相鉴
别。

%Objective To summary characteristics of color Doppler sonography
on branchial cleft cyst and fistula, in order to decrease misdiagnosis. Methods We retrospectively analyzed and compared the characteristics of color Doppler sonography of branchial cleft cyst and fistula in 17 cases confirmed by postoperative pathology. Results 12 patients were ad-mitted to our hospital with masses on side neck or under acoustic duct and 5 patients were found parotid and thyroid nodules in medical examinations. Only 7 cases were diagnosed correctly by color Doppler sonography
before operation in all recorded 17 cases of branchial cleft cyst and fistula, 10 patients were misdiagnosed. The rate of ultrasonic misdiagnosis for branchial cleft cyst and fistula was 58. 8%. 3 cases were misdiagnosed as the solid mass of parotid gland, 1 case was misdiagnosed as cyst of parotid gland, 1 case was misdiagnosed as thyroglossal cyst, 3 cases were misdiagnosed as lymphnoditis with liquefaction, and 2 cases were misdiagnosed as thyroid solid nodules. In our study, all cases were confirmed by postoperative pathology:11 ca-ses were branchial cleft cyst and 6 cases were branchial fistula. The coincidence rate between color Doppler sonography diag-nosis and pathology was 41. 2% (7/17). Conclusion Branchial cleft cyst and fistula can be diagnosed based on ultrasono-graphic features of color Doppler sonography and clinical manifestations, but physicians should also pay attention to distinguis-hing it with other cystic neck lesions because it may be misdiagnosed easily for various factors.
【总页数】4页(P43-46)
【作者】张云山;邱璇;李进让;刘秋颖;杨克;余泽辉;付万袭
【作者单位】100048 北京，海军总医院超声医学科;100048 北京，海军总医院超声医学科;100048 北京，海军总医院耳鼻喉科;100048 北京，海军总医院超声医学科;100048 北京，海军总医院超声医学科;100048 北京，海军总医院超声医学科;100048 北京，海军总医院超声医学科
【正文语种】中文
【中图分类】R445.1;R739.91
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