• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Thyroglossal Duct Cyst甲狀舌管囊腫

    2019-05-20 05:53:12關(guān)鍵
    影像診斷與介入放射學(xué) 2019年2期
    關(guān)鍵詞:狀葉盲孔舌骨

    Key Facts

    Definition:Thyroglossal duct cyst (TGDC) is remnant of thyroglossal duct found between foramen cecum of tongue base and thyroid bed of infrahyoid neck.

    Classic imaging appearance:Cystic neck mass with thin rim of peripheral enhancement, located in midline.Can occur in tongue base, at hyoid bone,or embedded in infrahyoid strap muscles.The more inferior the TGDC, the more paramedian.Most common congenital neck lesion and 90% of nonodontogenic congenital cysts.

    Presents as asymptomatic midline or paramedian neck mass.

    Imaging Findings

    General features:(1)Best imaging clue is midline cystic neck mass embedded in infrahyoid strap muscles ("claw sign").(2)TGDC is shown as benignappearing, cystic neck mass, and wall may enhance if infected.Location is important key to diagnosis.(3)Above hyoid bone, occurs at base of tongue or within posterior floor of mouth.At level of hyoid bone, found in midline abutting hyoid.May project into pre-epiglottic space.In infrahyoid neck,embedded in strap muscles.(4)Carcinoma is associated with TGDC (<1%).Differentiated thyroid Ca (85% papillary carcinoma).

    CT findings:(1)Low-density mass,occasionally septated.(2)If associated thy roid carcinoma, solid eccentric mass, without calcification.(3)Associated with cyst.

    MR findings:(1)Hypointensity on T1WI and hyperintensity on T2WI; (2)No enhancement (unless infected).

    Ultrasound Findings:Anechoic midline neck mass in close association with hyoid.

    Imaging recommendations:TGDC in children have a classic clinical presentation.Sonography to confirm normal thyroid gland.CT or MR more than adequate to task of defining nature and extent.Recommended if cyst is suprahyoid in location, if there is question about diagnosis, if mass is infected or recurrent, or when there is suspicion of associated carcinoma.

    Nuclear scintigraphy only if unable to identify normal thyroid gland.

    Differential Diagnosis: Anterior Neck Mass

    (1)Lingual or sublingual thyroid:Ectopic thyroidal tissue will enhance and appear solid on CT/MR.(2)Lymphadenopathy:Usually multiple,paramedian,non-cystic unless necrotic.(3)Dermoid of the tongue:Dermoid will be fat density on CT, hyperintense on enhanced T1WI.(4)Mixed laryngocele:Laryngocele can be traced back to laryngeal origin.Laryngocele will not be em bedded within strap muscles.(5)Malignant necrotic node, anterior neck (Delphian chain) may be difficult to differentiate necrotic node from infected TGDC.

    Pathology-Genetics

    Familial cases are rare, and usually autosomal dominant.Thyroid developmental anomalies often occur in the same family, including TGDC, agenesis,ectopia, pyramidal lobe.

    Embryology-Anatomy

    Thyroglossal duct originates near foramen cecum.Descends through base of tongue, floor of mouth, around or through hyoid bone area, anterior to strap muscles, to the final position in thyroid bed anterior to thyroid or cricoid cartilage.

    Fig 1 a)Axial T2WI and b)axial T1WI reveal a thyroglossal duct cyst (arrow)in the region of midline.c)Sagittal T2WI demonstrates a cyst(arrow)adjacent to hyoid bone.Fig 2 This drawing depicts the tract of the thyroglossal duct as it passes from the cephald foramen cecum (arrow) to the distal thyroid bed.The tract passes close to the mid-h(huán)yoid bone (open arrow).In the infrahyoid neck, the thyroglossal duct cyst fades off midline to a paramedian location.

    Etiology-Pathogenesis

    Failure of involution of thyroglossal duct and persistent secretion of epithelial cells lining duct result in TGDC.TGDC can occur anywhere along route of descent.Ectopic thyroid tissue can also occur anywhere along this course.

    Epidemiology

    TGDC is most common congenital neck mass.Female>Male if hereditary form.

    Gross Pathologic,Surgical Features

    Smooth, benign-appearing cyst, usually with a tract to the hyoid bone ± the foramen cecum.

    Microscopic Features

    Cyst lined by respiratory or squamous epithelium.

    Small deposits of thyroid tissue commonly associated.

    Clinical Issues

    Presentation:(1)Principal presenting symptom:midline neck mass.(2)Other presenting symptoms:recurrent,soft,mobile,asymptomatic,midline or slightly paramedian neck mass.(3)Often has a history of recurrent, intermittent neck swelling,or multiple prior incision and drainage procedures.(4)Age of presentation:<10 years (90%); 10% are 20-35 year olds.(5)Physical examination:when TGDC surrounds hyoid bone, it moves with tongue movement.

    Natural History

    Recurrent, intermittent swelling of mass, usually following a minor upper respiratory infection.

    Treatment & Prognosis

    Complete surgical resection, termed a sistrunk procedure.Entire cyst and midline portion of hyoid bone is resected and tract to foramen cecum dissected free, to prevent recurrence.Sistrunk procedure decreases recurrence rate from 4% to 50%.Excellent with complete surgical resection.Recurrences (incomplete resection) often complicated, lateral.

    醫(yī)學(xué)詞匯注釋與簡(jiǎn)要講解

    thyroglossal duct cyst 甲狀舌管囊腫

    foramen cecum 盲孔

    hyoid bone 舌骨

    odontogenic 牙源性的

    infrahyoid strap muscles 舌骨下帶肌

    pre-epiglottic 前會(huì)厭

    nuclear scintigraphyh 核素閃爍成像

    lingual 舌的

    sublingual 舌下的

    lymphadenopathy 淋巴結(jié)病變

    dermoid 皮樣囊腫

    laryngocele 喉膨出; 喉囊腫

    autosomal dominant 常染色體顯性

    agenesis 缺如

    ectopia 異位

    pyramidal lobe 錐狀葉

    cricoid cartilage 環(huán)狀軟骨

    epithelial cells 上皮細(xì)胞

    respiratory epithelium 呼吸上皮

    squamous epithelium 鱗狀上皮

    猜你喜歡
    狀葉盲孔舌骨
    完全腹腔鏡肝尾狀葉腫瘤切除術(shù)13例療效分析
    腹腔鏡下單獨(dú)肝尾狀葉腫瘤切除術(shù)3例報(bào)告
    盲孔內(nèi)反倒角的加工工藝研究
    兒童甲狀舌管囊腫分型及舌骨選擇性保留的探討*
    舌骨形態(tài)學(xué)與顯微結(jié)構(gòu)的觀測(cè)
    射孔槍耐壓性能的影響因素分析
    Budd-Chiari綜合征肝尾狀葉的形態(tài)學(xué)變化
    一種跨層盲孔制作及對(duì)位方式研究
    肝尾狀葉切除術(shù)的研究進(jìn)展
    一種快速填盲孔的工藝及原理研究
    扬中市| 同仁县| 梓潼县| 民权县| 陇西县| 巴马| 河间市| 西平县| 云浮市| 安仁县| 安顺市| 开远市| 芦山县| 县级市| 武安市| 朝阳市| 鄂伦春自治旗| 古交市| 道真| 卓尼县| 开鲁县| 和田市| 文昌市| 蒙城县| 保亭| 库尔勒市| 海南省| 汝州市| 铁岭市| 小金县| 晋江市| 古蔺县| 会宁县| 潍坊市| 邯郸市| 墨脱县| 泗洪县| 昌都县| 恩平市| 兴和县| 新昌县|