颈动脉间隙血管移位的方向在颈Ⅱ~Ⅳ区淋巴结源性及神经源性病变中的鉴别价值

Identification value of vascular displacement direction in carotid space on lymph node-derived and neurogenic lesions in neck Ⅱ-Ⅳ area

摘要:

目的：探讨颈动脉间隙血管移位的方向在颈Ⅱ~Ⅳ区淋巴结源性及神经源性病变中的鉴别价值。方法：收集重庆医科大学附属第一医院2017年1月1日至2019年4月15日经病理证实的位于颈Ⅱ~Ⅳ区的淋巴结源性（26例，其中淋巴结结核7例，淋巴结转移8例，淋巴瘤7例，淋巴结炎4例）及神经源性（7例，其中神经鞘瘤6例，神经纤维瘤1例）病变共33例，除了观察病灶大小、边界、形态、密度，强化方式、强化程度等直接征象外，还重点观察颈动脉间隙血管受压移位的方向。结果：２组病灶的大小（Z=-1.456，P=0.145）、边界（?字2=0.480，P=0.652）、形态（?字2=2.257，P=0.190）、密度（?字2=1.451，P=0.378）、强化方式（?字2=1.188，P=0.664）、强化程度（?字2=5.579，P=0.084）均无明显统计学差异；而淋巴结源性病变的颈动脉间隙血管向内移位为26例（100%），神经源性病变的颈动脉间隙血管向外移位6例（85.7%），向内移位1例（14.3%），差异具有统计学意义（?字2=27.238，P=0.000）。结论：颈动脉间隙血管移位的方向可作为颈Ⅱ~Ⅳ区淋巴结源性及神经源性病变的重要鉴别指标。

Abstract:

Objective：To investigate the identification value of vascular displacement direction in carotid space on lymph node-de－rived and neurogenic lesions in neck Ⅱ-Ⅳ area. Methods：A total of 33 patients whose lesions were pathologically confirmed in the neck Ⅱ-Ⅳ area from 1st January 2017 to 15th April 2019 were collected, including lymph node-derived lesion（n=26，including seven patients of lymph node tuberculosis，eight patients of lymph node metastasis，seven patients of lymphoma and four patients of lymphnoditis） and neurogenic lesion（n=7，including six patients of schwannoma and one patient of neurofibroma）. Besides the obvi－ous signs of lesion size，boundary，shape，density and enhancement ways and degree, the vascular displacement direction received more attention. Results：There were no significant differences in size（Z=-1.456，P=0.145），boundary（ ?字2=0.480，P=0.652），shape（?字2=2.257，P=0.190），density（ ?字2=1.451，P=0.378），ways of enhancement（ ?字2=1.188，P=0.664），and degree of enhancement（ ?字2=5.579，P=0.084） between two groups. In contrast，26 patients（100%） with lymph node lesion had inward displacement，carotid space vascular moving inside，six patients with neurogenic lesion（85.7%） had outward displacement，and one patient with neurogenic lesion（14.3%） had inward displacement, with statistically significant differences（ ?字2=27.238，P=0.000）. Conclusion：The direction of vascular displacement in carotid space can be used to identify the lesion from lymph node or nerve in the neck Ⅱ-Ⅳ area.