CAJ | 학술논문

目的：探讨CT对 Madelung综合征累及头颈部的诊断价值。方法：回顾性分析24例 Madelung 综合征累及头颈部患者的CT表现，全部病例均行CT平扫，15例行增强扫描，18例采用2D多平面重组（MPR）和3D容积再现（VR）技术进行图像后处理。结果：24例均显示脂肪组织对称分布，无包膜，边界不清。男性患者病变主要分布于下枕部、后颈部及上背部皮下间隙、胸锁乳突肌及斜方肌深面、椎旁肌间隙、颈前区、腮腺区、面颊部、颈后三角区和锁骨上区；女性患者病变主要累及后颈部皮下间隙。部分病例见肌肉、腺体、大血管、上气道和消化道受压。此外，CT扫描发现头颈部偶发病变5例，包括会厌癌、真菌性上颌窦炎、枕大池蛛网膜囊肿、腮腺 Warthin 瘤和锁骨上血管畸形各1例。结论：CT 是评价Madelung综合征累及头颈部的有效手段，结合2D MPR和3D VR重组技术，可准确显示脂肪组织的分布情况，病灶与肌肉、腺体和大血管的关系以及上气道和消化道受压的程度等，同时可发现头颈部其它偶发病变，对本病的诊断和治疗具有重要价值。
목적：탐토CT대 Madelung종합정루급두경부적진단개치。방법：회고성분석24례 Madelung 종합정루급두경부환자적CT표현，전부병례균행CT평소，15례행증강소묘，18례채용2D다평면중조（MPR）화3D용적재현（VR）기술진행도상후처리。결과：24례균현시지방조직대칭분포，무포막，변계불청。남성환자병변주요분포우하침부、후경부급상배부피하간극、흉쇄유돌기급사방기심면、추방기간극、경전구、시선구、면협부、경후삼각구화쇄골상구；녀성환자병변주요루급후경부피하간극。부분병례견기육、선체、대혈관、상기도화소화도수압。차외，CT소묘발현두경부우발병변5례，포괄회염암、진균성상합두염、침대지주망막낭종、시선 Warthin 류화쇄골상혈관기형각1례。결론：CT 시평개Madelung종합정루급두경부적유효수단，결합2D MPR화3D VR중조기술，가준학현시지방조직적분포정황，병조여기육、선체화대혈관적관계이급상기도화소화도수압적정도등，동시가발현두경부기타우발병변，대본병적진단화치료구유중요개치。
Objective:To study the value of CT for the diagnosis of Madelung syndrome involving head and neck. Methods:CT findings of 24 cases with Madelung syndrome involving head and neck were analyzed retrospectively.All cases underwent CT plain scan.Contrast enhanced CT scan was performed in 15 cases,2D multiplanar reformation (MPR)and 3D volume rendering (VR)reformation were performed in 18 cases.Results:All cases showed lesions symmetrically distri-buted,non-encapsulated and ill-defined.In male patients,massive fatty tissue mainly distributed in the subcutaneous space of lower occipital region,posterior part of neck and upper part of back,under the sternomastoid and trapezius muscles,space between paraspinal muscles,and in the anterior region of neck,parotid region,cheek,posterior cervical triangle and supracla-vicular fossa.In female patients,massive fatty tissue was mainly found in the subcutaneous space of posterior part of neck. Compression and deformation of muscle,gland,major blood vessels and upper aerodigestive tract were detected in some ca-ses.5 associated incidental lesions were revealed on CT,including epiglottic carcinoma,fungal maxillary sinusitis,arachnoid cyst of cistern magna,Warthin′s tumor of the parotid gland and supraclavicular vessel malformation for 1 case each.Conclu-sion:Madelung syndrome involving head and neck could be effectively evaluated by CT,using 2D MPR and 3D VR tech-niques simultaneously,CT can accurately depict the distribution of fat,relationship between fatty lesion and adjacent mus-cle,gland or major blood vessels,degree of compression of upper aerodigestive tract,and accompanied incidental lesions.CT provides important value in the diagnosis and treatment of this disease.