頸部腫瘤の画像診断

DOI Web Site 参考文献18件
  • 吉浦 一紀
    九州大学大学院歯学研究院口腔顎顔面病態学講座口腔画像情報科学分野
  • 筑井 徹
    九州大学大学院歯学研究院口腔顎顔面病態学講座口腔画像情報科学分野

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タイトル別名
  • Imaging diagnosis of the neck masses
  • ケイブ シュリュウ ノ ガゾウ シンダン

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Differential diagnosis of the neck masses is a little bit difficult. However, appropriate procedures for diagnostic imaging make it possible to focus on several possible lesions. First step to differential diagnosis is to localize the mass in a particular anatomical space using contrast enhanced CT or MM. This step facilitates the differential diagnosis by limiting the types of the lesions arising in the given anatomical location. The sites related to the neck masses are submandibular, carotid, parapharyngeal and parotid gland spaces. Displacement of the vessels is an important sign to differentiate lymph node diseases from other diseases. They are facial artery and vein in the submandibular space, and carotid artery and jugular vein in the carotid space. It is also difficult to differentiate among lymph node diseases. A combination of several imaging modalities, such as CT, MRI, and ultrasonography makes differential diagnosis more accurate. Lymph node diseases that must be differentiated each other are lymph node metastasis, malignant lymphoma, and lymphadenitis. Specific lymphadenitis such as tuberculosis must be also differentiated from simple lymphadenitis. Important findings for differential diagnosis are inflammatory changes in the border of the nodes or fascia, in CT, and echogenic hilum and vascularity in the ultrasonography. However, patient history, clinical findings, and laboratory data must be also considered to make the final clinical diagnosis.

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