Liu Jinghua, Yang Xiujun
Department of Radiology and Medicine Imaging，Shanghai Children's Hospital，Children's Hospital Affiliated to Shanghai Jiaotong University，Shanghai，200040，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Feb;34(2):146-149. doi: 10.13201/j.issn.1001-1781.2020.02.011.
The aim of this study is to evaluate the value of multi-slice spiral CT （CT） and multi-planar reconstruction （MPR） in the diagnosis of children with parotid cleft deformity. The CT images of 55 cases of branchial cleft deformity confirmed by surgery and pathology were retrospectively analyzed. CT examination showed that 37 cases had strip-like, tubular fistula or cystic mass located in the anterior cervical triangle, anterior margin of sternocleidomastoid muscle, and 2 of them had bilateral fistula structure. In 16 casescystic mass and tubular fistula were found in the parotid gland or at the edge of the parotid gland. One case was accompanied by atresia of the lateral auditory meatus. After contrast enhancement, the cystic wall（tube wall） of 55 patients were enhanced. In 9 patients with infection, the boundary of the lesion was blurred, and the density of the cyst or lumen increased after contrast enhancement. MSCT diagnosed 6 cases of parotid cleft cyst with fistula, 35 cases of branchial cleft cyst, 13 cases of parotid fistula, and 1 case misdiagnosed as lymphadenitis. Among all the cases, 15 were type Ⅰ, 36 were type Ⅱand 4 were type Ⅲ. Compared with the results of pathological diagnosis and clinical operation, the accuracy of qualitative diagnosis and localization was 99.9% and 100.0%. Multi-slice spiral CT thin-slice images combined with MPR image post-processing technology can better display the location of branchial cyst and the course of branchial fistula.
本研究旨在评估多层螺旋CT（CT）及多平面重建（MPR）在小儿腮腺裂畸形诊断中的价值。回顾性分析55例经手术及病理证实的鳃裂畸形患儿的CT图像。CT检查显示，37例在颈前三角、胸锁乳突肌前缘见条状、管状瘘管或囊性肿物，其中2例为双侧瘘管结构。16例在腮腺内或腮腺边缘见囊性肿物及管状瘘管。1例伴有外耳道闭锁。增强扫描后，55例患者的囊壁（管壁）均有强化。9例感染患者病变边界模糊，增强扫描后囊肿或管腔密度增高。MSCT诊断腮腺裂囊肿伴瘘6例，鳃裂囊肿35例，腮腺瘘13例，误诊为淋巴结炎1例。所有病例中，Ⅰ型15例，Ⅱ型36例，Ⅲ型4例。与病理诊断及临床手术结果相比，定性诊断及定位的准确率分别为99.9%和100.0%。多层螺旋CT薄层图像结合MPR图像后处理技术能更好地显示鳃裂囊肿的位置及鳃裂瘘管的走行。
