Domínguez García C, González Ruiz Y, Fernández Atuan R, Bragagnini Rodríguez P, Siles Hinojosa A, Salcedo Arroyo P, Ruiz de Temiño M
Hospital Universitario Miguel Servet. Zaragoza (Spain).
Complejo Hospitalario de Navarra. Pamplona (Spain).
Cir Pediatr. 2020 Jan 20;33(1):16-19.
Evaluate ultrasound (US) sensitivity and specificity in suspected thyroglossal duct cysts (TGDC) undergoing surgery in our hospital, and their correlation with surgical findings.
Retrospective study of 150 patients undergoing surgery for midline neck mass suggestive of TGDC (2008-2018). We analyzed epidemiological variables and compared the correlation between diagnostic ultrasound imaging and surgical findings, considering previous episodes of local infection.
Mean age at surgery was 3.96 years (0.75-12.58 years). Of the 150 patients, 81 were male and 69 were female. Following ultrasound examination, 110 were suspected to have TGDC, and diagnosis was confirmed after surgery in 80 cases. Of the remaining 40 cases without TGDC-compatible US examination, TGDC was confirmed in 15 cases. The rest were diagnosed with dermoid cyst (49), lymphadenopathy (4), and vascular malformation (2). US sensitivity was 84%, while specificity was 45%, with a positive predictive value of 73%, and a negative predictive value of 62%. In 62.1% (59) of TGDCs, a previous infection episode had been described, with 16.7% of cases requiring surgical drainage. 13.6% had recurrence after Sistrunk technique. There was no statistically significant relationship between previous infection episodes and postsurgical recurrence, or between surgical or spontaneous drainage and cyst recurrence.
Even though US role in eutopic thyroid gland identification cannot be doubted, it provides with low specificity in the study of midline neck masses. Therefore, the physician's opinion should be prioritized.
评估我院手术治疗的疑似甲状舌管囊肿（TGDC）患者中超声（US）的敏感性和特异性，以及它们与手术结果的相关性。
回顾性研究2008 - 2018年间因中线颈部肿块提示TGDC而接受手术的150例患者。我们分析了流行病学变量，并比较了诊断性超声成像与手术结果之间的相关性，同时考虑既往局部感染情况。
手术时的平均年龄为3.96岁（0.75 - 12.58岁）。150例患者中，男性81例，女性69例。超声检查后，110例被怀疑患有TGDC，术后80例确诊。其余40例超声检查结果不支持TGDC的患者中，15例确诊为TGDC。其余患者被诊断为皮样囊肿（49例）、淋巴结病（4例）和血管畸形（2例）。US的敏感性为84%，特异性为45%，阳性预测值为73%，阴性预测值为62%。在62.1%（59例）的TGDC患者中，曾有过感染发作，其中16.7%的病例需要手术引流。Sistrunk技术术后复发率为13.6%。既往感染发作与术后复发之间，手术或自发引流与囊肿复发之间均无统计学显著关系。
尽管超声在正常位置甲状腺识别中的作用毋庸置疑，但在中线颈部肿块的研究中其特异性较低。因此，应优先考虑医生的意见。
