Moon W K, Han M H, Chang K H, Im J G, Kim H J, Sung K J, Lee H K
Department of Radiology, Seoul National University College of Medicine, Korea.
Radiographics. 1997 Mar-Apr;17(2):391-402. doi: 10.1148/radiographics.17.2.9084080.
Tuberculosis of the head and neck can involve the cervical lymph nodes, larynx, temporal bone, sinonasal cavity, eye, pharynx, thyroid gland, and skull base. Although computed tomography (CT) and magnetic resonance (MR) imaging can accurately demonstrate the sites, pattern, and extent of the disease, both modalities have limitations in the evaluation of head and neck tuberculosis. Imaging and clinical features of head and neck tuberculosis are often varied and nonspecific and frequently mistaken for those of carcinoma. However, tuberculous lymphadenitis is often characterized by areas of low attenuation or low signal intensity with rim enhancement or calcification, and laryngeal tuberculosis usually manifests as a diffuse bilateral lesion with or without a focal mass. A thorough knowledge of head and neck tuberculosis is important because early diagnosis and therapy may prevent a permanent loss of function or needless surgery.
头颈部结核可累及颈部淋巴结、喉、颞骨、鼻窦腔、眼、咽、甲状腺及颅底。虽然计算机断层扫描(CT)和磁共振成像(MR)能够准确显示病变的部位、形态及范围,但这两种检查方法在评估头颈部结核时均存在局限性。头颈部结核的影像学表现和临床特征往往多样且不具特异性,常被误诊为癌。然而,结核性淋巴结炎通常表现为低密度或低信号区,周边强化或伴有钙化,而喉结核通常表现为双侧弥漫性病变,可伴有或不伴有局灶性肿块。对头颈部结核有全面的认识很重要,因为早期诊断和治疗可预防功能的永久性丧失或不必要的手术。