Buterbaugh J E, Erly W K
Department of Radiology, University of Arizona College of Medicine, Tucson, AZ 85724, USA.
AJNR Am J Neuroradiol. 2008 Jun;29(6):1218-21. doi: 10.3174/ajnr.A1058.
Collections of extraluminal paratracheal gas may be present on CT images of the neck and cervical spine and the radiologist may question whether this is related to a pathologic process. This study is designed to demonstrate the appearance, clinical presentation, and prevalence of paratracheal air cysts, which, on CT examinations of the neck, can mimic abnormal extraluminal air.
From January 1, 2005, through May 22, 2005, a total of 702 CT examinations of the cervical spine or soft tissue of the neck were reviewed. All examinations were at 2- to 5-mm thickness. Sagittal and coronal reconstructions were available for review, if necessary. Paratracheal air cysts were evaluated for size; the presence of visible communication with the trachea; association with pneumothorax, pneumomediastinum, or subcutaneous emphysema; and association with findings of emphysematous changes in the lung apices. Patient demographics of age, sex, and whether the patient had sustained a traumatic injury were also collected.
Of the 702 patients evaluated, 26 (3.7%) had paratracheal air cysts, all of which were found on the right, at the level of the thoracic inlet. Ages of the patients ranged from 15 to 74 years. In 9 (34.6%) of the patients, a direct communication with the trachea was seen. Sizes of the paratracheal air cysts ranged from 1 x 2 mm to 10 x 15 mm. No association was found with CT findings of emphysema in the lung apices, abnormal soft tissue air, or trauma.
Right paratracheal air cysts are a common CT finding that occur in a predictable location. In the setting of trauma, these characteristic structures can mimic pneumomediastinum and are seen in approximately 3% to 4% of the US population. The cause is unclear but may be either congenital or an acquired phenomenon, given that they are often seen in both children and adults. We found no association with either trauma or the presence of emphysematous changes in the lung apices.
颈部和颈椎的CT图像上可能会出现气管旁腔外气体聚集，放射科医生可能会质疑这是否与病理过程有关。本研究旨在展示气管旁气囊肿的表现、临床表现及患病率，在颈部CT检查中，气管旁气囊肿可模拟异常的腔外气体。
回顾2005年1月1日至2005年5月22日期间共702例颈椎或颈部软组织的CT检查。所有检查层厚为2至5毫米。必要时可进行矢状面和冠状面重建以供查看。对气管旁气囊肿的大小、与气管是否存在可见的连通、与气胸、纵隔气肿或皮下气肿的关联以及与肺尖部气肿性改变的发现的关联进行评估。还收集了患者的年龄、性别以及是否遭受创伤的人口统计学数据。
在评估的702例患者中，26例（3.7%）有气管旁气囊肿，均位于右侧胸廓入口水平。患者年龄范围为15至74岁。9例（34.6%）患者可见与气管直接连通。气管旁气囊肿大小范围为1×2毫米至10×15毫米。未发现与肺尖部肺气肿的CT表现、异常软组织气体或创伤有关联。
右侧气管旁气囊肿是常见的CT表现，出现在可预测的位置。在创伤情况下，这些特征性结构可模拟纵隔气肿，在美国人群中约3%至4%可见。病因尚不清楚，但鉴于其在儿童和成人中均常见，可能是先天性或后天性现象。我们未发现其与创伤或肺尖部气肿性改变有关联。
