欢迎访问《中国循证儿科杂志》官方网站，今天是
English Version
中国循证儿科杂志

中国循证儿科杂志 ›› 2016, Vol. 11 ›› Issue (2): 104-108.

• 论著 • 上一篇    下一篇

临床结合影像学指标对儿童颈前区甲状舌管囊肿诊断准确性研究

柏梅1 武兵2 谢梓建3 杨鸣姝1 季敏1 乔中伟1   

  1. 1 复旦大学附属儿科医院放射科 上海，201102；2 山东省枣庄市妇幼保健院放射科 枣庄，277100；3 福建省福州儿童医院放射科 福州，350005
  • 收稿日期:2015-04-29 修回日期:2016-04-21 出版日期:2016-04-25 发布日期:2016-04-21
  • 通讯作者: 乔中伟

The diagnosis of thyroglossal duct cyst in anterior cervical region in children: clinical and radiological appearance

BAI Mei1, WU Bin2, XIE Zi-jian3, YANG Ming-shu1, JI Ming1，QIAO Zhong-wei 1   

  1. 1 Department of Radiology, Children′s Hospital of Fudan University, Shanghai 201102; 2  Department of Radiology, Maternal and Child Health Care of Zaozhuang, Shandong Province, Zaozhuang 277100；3 Department of Radiology,Fuzhou Children′s Hospital, Fujian Province, Fuzhou 350005, China
  • Received:2015-04-29 Revised:2016-04-21 Online:2016-04-25 Published:2016-04-21
  • Contact: QIAO Zhong-wei

PDF

990

摘要：

目的 探讨临床结合影像学指标对儿童颈前区甲状舌管囊肿（TDC）的诊断价值。 方法 纳入复旦大学附属儿科医院2012年9月至2014年10月经手术病理证实的颈前部囊性病变、且术前行CT或MRI检查的患儿。以手术病理诊断为依据分为TDC组和非TDC组（颈前部其他囊性病变）。选择以下6项临床和影像学指标：①体格检查中囊肿是否随吞咽和伸舌而运动；②囊肿在CT、MRI上的解剖分区；③囊肿是否紧贴舌骨；④囊肿是否位于或偏离颈部中线；⑤囊肿在CT上的密度；⑥囊肿的最大直径。6项指标先行单因素分析，差异有统计学的指标计算单一指标和组合指标诊断TDC的敏感度、特异度、阳性预测值、阴性预测值及其95%CI。结果 49例颈前部囊性病变进入本文分析，TDC组32例，男19例，年龄 (3.9±2.7）岁；非TDC组17例，男7例，年龄（5.2±3.0）岁，包括表皮样囊肿9例、皮样囊肿4例、畸胎样囊肿1例、囊性淋巴管瘤2例、舌下腺囊肿1例。TDC组32例行CT检查，2例行MR检查；非TDC组15例行CT检查，2例行MR检查。①单因素分析显示，囊肿随吞咽和伸舌运动、囊肿紧贴舌骨、囊肿在颈部分区的分布两组差异有统计学意义。②囊肿随吞咽运动、囊肿位于下颌下区和囊肿紧贴舌骨诊断TDC的敏感度分别为75.0%、65.6%和68.8%，特异度分别为70.6%、94.1%和82.4%；满足上述3项指标中任一项诊断TDC的敏感度为93.8%，特异度为29.4%；3项指标均满足的敏感度为0，特异度为100%；囊肿位于下颌下区和囊肿紧贴舌骨指标满足任一项，敏感度为84.4%，特异度为82.4%。结论 体格检查联合影像学检查对于儿童TDC具有较高的诊断价值。

Abstract:

Objective To diagnose thyroglossal duct cysts (TDCs) in anterior cervical region in children based on imaging findings and clinical physical examnination. Methods Forty-nine patients with suspected congenital midline cervical anomalies in anterior cervical region and with radiologic images before surgery were categorized into TDCs group and non-TDCs group depending on their histopathologic diagnosis from September 2012 to October 2014. Comparative study was performed between the two groups with following 6 indicators: movement of cysts with deglutition and protrusion of the tongue ,the location of cysts in CT and MRI,close proximity to the hyoid bone,relationship to the midline, density and size.Then the sensitivity,specificity,false positive ratio,positive predictive value,negative predictive value and 95%CI of single or combined indicators with statistical differences were evaluated. Results Of the 49 pediatric patients,32 patients［(3.9±2.7) years old,19 boys］ had histopathologically confirmed as TDCs. Other 17 patients［(5.2±3.0) years old,7 boys］ had epidermoid cysts(n=9),dermoid cysts (n=4),teratoid cyst (n=1),ranula (n=1), and cystic lymphangioma (n=2). ①Single factor analysis showed there were statistically significant differences in movements with deglutition and protrusion of the tongue, the location and relationship to the hyoid bone of cysts between the two groups. There were no statistical differences in relationship to the midline and size of masses between the two groups. ②The sensitivities of each 3 indicators (cysts moving with deglutition and protrusion of tongue,cysts in close promixity to hyoid bone, cysts located in submandibular region) were 75.0%,65.6%,68.8% respectively, and specificities were 70.6%,94.1%,82.4% respectively for TDCs. The sensitivity and specificity of any one of these 3 indicators were 93.8%,29.4% respectively for TDCs.The sensitivity and specificity of all these 3 indicators were 0%,100% respectively for TDCs .The sensitivity and specificity of any one of these 2 indicators(cysts in close promixity to hyoid bone, cysts located in submandibular region) were 84.4%,82.4% respectively. Conclusion It is very useful to diagnose TDCs in anterior cervical region with clinical physical examination and radiologic imaging in chilidren.