1
|
Preoperative ultrasound for the diagnosis of thyroglossal duct cysts: A validation study. Int J Pediatr Otorhinolaryngol 2019; 122:89-92. [PMID: 30991206 DOI: 10.1016/j.ijporl.2019.03.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the use of ultrasound to distinguish between thyroglossal duct cysts (TGDC) and dermoid cysts (DC) for surgical planning. To validate the SIST (septae + irregular wall + solid components = TGDC) scoring system proposed by Oyewumi et al. [1]. METHODS This was a retrospective chart review of pediatric patients with midline neck masses who presented between the years of 2005 and 2014 and underwent preoperative ultrasound and surgical resection. Two pediatric radiologists blinded to diagnosis reviewed each US for 14 separate characteristics. According to the SIST scoring system, one point was given for each of the following: internal septae, irregular walls, and solid components. RESULTS 45 patients met inclusion criteria. Final pathologic diagnosis showed 29 patients had TGDC, 16 had DC. The majority of patients with both TGDC and DC earned SIST scores of 0. CONCLUSION While ultrasound remains a useful part of the work-up of lesions of the head and neck in children, this small retrospective study was not able to validate the previously proposed SIST scoring system None of the parameters discussed in the original paper was found to be a statistically significant determinant of TGDC.
Collapse
|
2
|
Pitner H, Elmaraghy C, Fischer B, Onwuka A, Rabe A, Walz P. Diagnostic Accuracy of Midline Pediatric Neck Masses. Otolaryngol Head Neck Surg 2019; 160:1111-1117. [DOI: 10.1177/0194599819827845] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To assess clinical evaluation, ultrasound, and previously published predictive score at preoperatively diagnosing midline neck masses and demographic or clinical associations that aid in differentiation of thyroglossal duct and dermoid cysts. Study Design Retrospective chart review. Setting Tertiary care children’s hospital. Subjects Patients <18 years undergoing primary midline neck mass surgery with histopathologic diagnosis of thyroglossal duct or dermoid cyst who had preoperative ultrasound performed were included. Methods An electronic medical record query generated 142 patients whose histopathologic diagnosis was thyroglossal duct cysts (TGDCs) or dermoid cysts (DCs). Charts were reviewed for demographic and clinical features. A radiologist blindly reviewed patients’ ultrasounds for SIST (septae + irregular walls + solid components = thyroglossal) score components. Each patient received 3 preoperative diagnoses: clinical, ultrasound, and SIST. Statistical analyses were conducted to determine association of demographic, clinical, or radiographic variables with diagnoses. Specificity, sensitivity, and predictive values were evaluated for each candidate diagnosis. Results There were 83 TGDCs and 59 DCs. Tenderness, infection history, depth relative to strap muscles, and SIST components were more common among TGDCs. Sensitivity and positive and negative predictive values surpassed 63% for each diagnostic modality. SIST score outperformed other diagnostic modalities with sensitivity, positive predictive value, and negative predictive value of 84%, 91%, and 81%, respectively. Clinical and ultrasound assessments were largely inconclusive for dermoid cysts, but SIST correctly identified 89% of DCs. Conclusion SIST score was the most accurate predictor of pediatric midline neck masses. Clinical and radiographic findings may help guide preoperative diagnosis, although further evaluation is required to develop more efficacious diagnostic tools.
Collapse
Affiliation(s)
- Hilary Pitner
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Charles Elmaraghy
- Department of Pediatric Otolaryngology, Nationwide Children’s Hospital, Columbus, Ohio, USA
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Beth Fischer
- Center for Surgical Outcomes Research, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Amanda Onwuka
- Center for Surgical Outcomes Research, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Andrew Rabe
- Department of Radiology, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Patrick Walz
- Department of Pediatric Otolaryngology, Nationwide Children’s Hospital, Columbus, Ohio, USA
- Department of Otolaryngology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| |
Collapse
|
3
|
Moon SM, Lee SM, Kang H, Choi HJ. Presternal subcutaneous bronchogenic cyst in adolescence: A case report and unusual ultrasonographic findings. Medicine (Baltimore) 2017; 96:e6054. [PMID: 28151916 PMCID: PMC5293479 DOI: 10.1097/md.0000000000006054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Subcutaneous bronchogenic cysts have been described rarely, particularly among adolescents. Only a few reports have described the ultrasonographic features of bronchogenic cysts, characterizing them as nonspecific cystic masses with or without internal echogenic foci or debris. Therefore, it is hard to differentiate subcutaneous bronchogenic cysts from other subcutaneous cystic tumors ultrasonographically.We report a case of presternal subcutaneous bronchogenic cyst in an 18-year-old man with unusual ultrasonographic findings. Ultrasonography revealed a small, oval, cystic mass containing a well-circumscribed, heterogeneously hypoechoic, egg-shaped lesion in the dependent portion of the mass within the subcutaneous fat layer overlying the sternum.Surgical excision was performed, and the cystic mass was diagnosed as a bronchogenic cyst. On pathological examination, the internal, heterogeneously hypoechoic, ball-like lesion was found to be mucous material within the cyst. To our knowledge, this is the first reported case of a presternal subcutaneous bronchogenic cyst presenting with a ball-like lesion inside of the cyst. This unusual ultrasonographic feature can be a clue to the diagnosis of subcutaneous bronchogenic cyst.In conclusion, if an anechoic cyst containing an internal, well-circumscribed, hypoechoic ball-like lesion is seen in the presternal subcutaneous fat layer, subcutaneous bronchogenic cyst should be considered in the differential diagnosis of subcutaneous cystic masses.
Collapse
Affiliation(s)
| | | | - Haeyoun Kang
- Department of Pathology, CHA Bundang Medical Center, CHA University, College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do
| | - Hye Jeong Choi
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| |
Collapse
|
4
|
Oyewumi M, Inarejos E, Greer ML, Hassouneh B, Campisi P, Forte V, Propst EJ. Ultrasound to differentiate thyroglossal duct cysts and dermoid cysts in children. Laryngoscope 2014; 125:998-1003. [PMID: 25234770 DOI: 10.1002/lary.24934] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 07/29/2014] [Accepted: 08/25/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine if ultrasound could differentiate between thyroglossal duct cysts (TGDC) and midline dermoid cysts (DC). STUDY DESIGN Cohort study. METHODS A search of pathology reports yielded 91 patients with TGDC or midline DC. Ultrasound images were presented to a radiologist blinded to pathology who evaluated the following: 1) depth of lesion from skin, 2) maximum diameter, 3) dimensions, 4) midline location, 5) distance from base of tongue, 6) tract, 7) wall regularity, 8) wall thickness, 9) margin definition, 10) heterogeneity, 11) internal septae, 12) solid components, 13) intralesional Doppler flow, and 14) posterior enhancement. The predictive power of these variables was evaluated in a multiple logistic regression model. RESULTS There were 53 TGDC and 38 DC. TGDC were significantly more likely than DC to have the following features: 1) smaller distance from base of tongue, 2) tract, 3) irregular wall, 4) ill-defined margin, 5) internal septae, 6) solid components, and 7) intralesional Doppler flow. Three clinically reliable ultrasound variables were independently able to discriminate between TGDC and DC. A predictive model was fashioned whereby each variable was scored as 0 or 1, with a total score calculated (septae + irregular wall + solid components = TGDC [or SIST] score). We propose a scoring system whereby 0 = suggestive of DC; 1 = suggestive of TGDC; and ≥2 = highly suggestive of TGDC. CONCLUSIONS It may be possible to differentiate between TGDC and midline DC preoperatively using ultrasound.
Collapse
Affiliation(s)
- Modupe Oyewumi
- Department of Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, Hamilton, Canada
| | | | | | | | | | | | | |
Collapse
|
5
|
AIUM practice guideline for the performance of ultrasound examinations of the head and neck. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:366-382. [PMID: 24449746 DOI: 10.7863/ultra.33.2.366] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
6
|
Chou J, Walters A, Hage R, Zurada A, Michalak M, Tubbs RS, Loukas M. Thyroglossal duct cysts: anatomy, embryology and treatment. Surg Radiol Anat 2013; 35:875-81. [PMID: 23689821 DOI: 10.1007/s00276-013-1115-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Accepted: 03/29/2013] [Indexed: 11/29/2022]
Abstract
Thyroglossal duct cysts are the most frequently encountered congenital abnormality of the neck, and are described extensively in the literature. The high incidence of this abnormality and its presence in all age groups requires clinicians to be aware of the clinical features, etiology, and current treatment options. Because it is readily accessible, relatively inexpensive, and non-invasive, sonography is arguably the ideal initial investigation. Computerized tomography and fine needle aspiration biopsy are often utilized as supplementary techniques for confirmation of the diagnosis. The treatment of choice for thyroglossal duct cysts continues to be the classic Sistrunk procedure, developed in 1920, although several modifications have since been employed. In this review, we aim to explore the embryological development, clinical presentation and diagnostic features of thyroglossal duct cysts. In addition, a useful adaptation to the Sistrunk procedure and the recent application of OK-432 therapy as a promising alternative for treatment of thyroglossal duct cysts will also be discussed.
Collapse
Affiliation(s)
- Jackie Chou
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada, West Indies
| | | | | | | | | | | | | |
Collapse
|
7
|
López García J, González-Moncayo García S, García Blázquez E. Quiste tirogloso con extensión mediastínica. Cir Esp 2011; 89:401-2. [DOI: 10.1016/j.ciresp.2010.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 06/24/2010] [Accepted: 06/25/2010] [Indexed: 11/24/2022]
|
8
|
|
9
|
Imaging of superficial and deep fibromatosis. Radiol Med 2009; 114:1292-307. [PMID: 19789958 DOI: 10.1007/s11547-009-0458-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Accepted: 11/03/2008] [Indexed: 12/15/2022]
Abstract
The purpose of this paper was to illustrate the role of diagnostic imaging in superficial and deep fibromatosis through a review of the use of different imaging modalities, including radiography, ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), angiography and scintigraphy. In particular, in agreement with published data, it emphasises the crucial role of MRI as the primary modality providing the information needed for management decisions, preoperative planning and follow-up of these lesions.
Collapse
|
10
|
Kutuya N, Kurosaki Y. Sonographic assessment of thyroglossal duct cysts in children. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2008; 27:1211-1219. [PMID: 18645080 DOI: 10.7863/jum.2008.27.8.1211] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The purpose of this study was to clarify the sonographic features of thyroglossal duct cysts (TDCs) in children. We also investigated how the presence of inflammation influences the sonographic appearance. METHODS We reviewed the sonograms from 36 children (0.5-14 years old) with pathologically proven TDCs. The lesions were evaluated for location, shape, internal echo pattern, internal septa, wall thickness, posterior enhancement, solid components, margins, and fistulas. The sonographic features of 7 lesions that pathologically showed inflammation were also investigated. RESULTS Most TDCs were midline (77.8%), were located at the hyoid bone (44.4%) or were infrahyoid (38.9%), showed posterior enhancement (77.8%), were unilocular (86.1%), lacked internal septa (91.7%), and had a thin wall (75%). None had a solid component. The internal echo patterns were classified into 4 types: anechoic (25%), homogeneously hypoechoic (16.7%), pseudosolid (16.7%), and heterogeneous (41.6%). Inflammation was confirmed in 78% of the lesions with wall thickening and 100% of the lesions with internal septa. CONCLUSIONS Most TDCs in children had echogenicity ranging from hypoechoic to heterogeneous. A thick wall and internal septa were considered to correlate with the presence of inflammation but not with the internal echo patterns of TDCs.
Collapse
Affiliation(s)
- Naoki Kutuya
- Department of Radiology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
| | | |
Collapse
|
11
|
|
12
|
Case 4. Ultrasound Q 2006. [DOI: 10.1097/01.ruq.0000224306.16974.c0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
13
|
|
14
|
Dudkiewicz I, Ganel A, Blankstein A. Congenital muscular torticollis in infants: ultrasound-assisted diagnosis and evaluation. J Pediatr Orthop 2006; 25:812-4. [PMID: 16294141 DOI: 10.1097/01.bpo.0000184648.81109.75] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Ultrasonography is considered the modality of choice for differentiating congenital muscular torticollis from other pathologies in the neck. The authors present their experience with ultrasound examination for the evaluation and management of congenital muscular torticollis. Twenty-six infants, 14 boys and 12 girls, age ranging from 1 to 16 weeks, with torticollis and a palpable mass were examined. Ultrasound showed a well-defined mass in the sternocleidomastoid muscle. The lesions ranged in size from 8 to 15.8 mm on maximal transverse diameter, with length ranging from 13.7 to 45.8 mm. Clinically the torticollis disappeared between 1 to 6 weeks, with complete clinical reduction of the palpated mass between 2 and 8.5 weeks. The ultrasonographic disappearance of the mass was delayed by an average of 2 weeks in comparison to the clinical disappearance of the mass. Ultrasound is advocated for the diagnosis and follow-up of congenital muscular torticollis because it noninvasively provides reliable and dynamic information without sedation.
Collapse
Affiliation(s)
- Israel Dudkiewicz
- Department of Orthopaedic Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer, Israel.
| | | | | |
Collapse
|
15
|
Chen MM, Chang HC, Hsieh CF, Yen MF, Chen THH. Predictive Model for Congenital Muscular Torticollis: Analysis of 1021 Infants With Sonography. Arch Phys Med Rehabil 2005; 86:2199-203. [PMID: 16271571 DOI: 10.1016/j.apmr.2005.05.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2005] [Revised: 04/30/2005] [Accepted: 05/14/2005] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To construct a predictive model to foretell congenital muscular torticollis (CMT) on the basis of clinical correlates. DESIGN Correlation study. SETTING Regional hospital. PARTICIPANTS A consecutive series of 1021 newborn infants. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Participants underwent portable ultrasonography to diagnose CMT. Significant clinical correlates were identified to construct a predictive model using the logistic regression model. RESULTS Forty of 1021 infants were diagnosed with CMT using ultrasonography, yielding an overall incidence of 3.92%. Birth body length (odds ratio [OR]=1.38; 95% confidence interval [CI], 1.49-2.38), facial asymmetry (OR=21.75; 95% CI, 6.6-71.7), plagiocephaly (OR=22.3; 95% CI, 7.01-70.95), perineal trauma during delivery (OR=4.26; 95% CI, 1.25-14.52), and primiparity (OR=6.32; 95% CI, 2.34-17.04) were significant correlates. A predictive logistic regression model with the incorporation of these 4 correlates was developed. We used cross-validation with a receiver operating characteristic curve to validate the predictive model. CONCLUSIONS Our study successfully developed a quantitative predictive model for estimating the risk of CMT on the basis of clinical correlates only. This model has good discriminative ability for classifying CMT and non-CMT by yielding acceptable values of false-negative and false-positive cases.
Collapse
Affiliation(s)
- Miao-Ming Chen
- Department of Rehabilitation, Li Shin Hospital, Taoyuan County, Taiwan
| | | | | | | | | |
Collapse
|
16
|
Styczynski J, Lasek W, Wysocki M. Calcified fibromatosis of the neck in 4-year old girl: rapid growth, rapid therapy. Int J Pediatr Otorhinolaryngol 2005; 69:847-52. [PMID: 15885340 DOI: 10.1016/j.ijporl.2005.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2004] [Accepted: 01/04/2005] [Indexed: 11/20/2022]
Abstract
Fibromatosis is a rare soft tissue disease typical for infants and characterized by fibroblastic proliferation, which may appear similar to fibrosarcoma. An unusual case of 4-year old girl presenting large tumor of the neck with massive calcification is described. The growth of the tumor was rapid and mediastinal involvement was observed. The final diagnosis showed benign nature of tumor with microscopic features of fibromatosis calcificans. After surgical resection of neck tumor, residual mass persisted both in the neck and in the mediastinum in 6 years of follow-up without signs of progression.
Collapse
Affiliation(s)
- Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, University of Nicolaus Copernicus, ul. Curie-Sklodowskiej 9, 85-094 Bydgoszcz, Poland.
| | | | | |
Collapse
|
17
|
|
18
|
Ahuja AT, Wong KT, King AD, Yuen EHY. Imaging for thyroglossal duct cyst: the bare essentials. Clin Radiol 2005; 60:141-8. [PMID: 15664568 DOI: 10.1016/j.crad.2004.08.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2004] [Revised: 08/12/2004] [Accepted: 08/16/2004] [Indexed: 11/25/2022]
Abstract
Thyroglossal duct cyst is the most common congenital cyst in the head and neck, and imaging features have been well documented in the literature. However, there are several practical important points to bear in mind during preoperative imaging, which are often overlooked. This review aims to summarize the imaging findings and emphasize important points for trainees and radiologists, particularly those who may encounter this lesion infrequently.
Collapse
Affiliation(s)
- A T Ahuja
- Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong SAR.
| | | | | | | |
Collapse
|
19
|
Tang SFT, Hsu KH, Wong AMK, Hsu CC, Chang CH. Longitudinal followup study of ultrasonography in congenital muscular torticollis. Clin Orthop Relat Res 2002:179-85. [PMID: 12360024 DOI: 10.1097/00003086-200210000-00026] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
High-resolution ultrasonography was used to examine affected sternocleidomastoid muscles in patients with congenital muscular torticollis at different times. Thirty-one female and 42 male patients were recruited and classified as having one of four types of fibrosis based on the sonograms. Compared with initial assessment, 22 (95.6%) patients with Type I fibrosis and 22 (57.9%) patients with Type II fibrosis had a change in classification at the end of the study. Among the patients with Type I fibrosis, the classification of one patient was changed to Type III fibrosis, the classifications of two patients were changed to normal muscle, and the classifications of the other patients were changed to Type II fibrosis. For patients with Type II fibrosis, the classifications of two patients were changed to Type III fibrosis, the classifications of three patients were changed to Type IV fibrosis, and the classifications of the other patients were changed to normal muscle. No changes in classification of patients with Types III and IV fibrosis occurred during followup. Patients with Type IV fibrosis had a significantly high incidence of surgical intervention. Congenital muscular torticollis is a dynamic disease. Ultrasonography can be valuable in observing the alteration. Aggressive management may be necessary for patients with Type IV fibrosis.
Collapse
Affiliation(s)
- Simon F T Tang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taiwan
| | | | | | | | | |
Collapse
|
20
|
Robbin MR, Murphey MD, Temple HT, Kransdorf MJ, Choi JJ. Imaging of musculoskeletal fibromatosis. Radiographics 2001; 21:585-600. [PMID: 11353108 DOI: 10.1148/radiographics.21.3.g01ma21585] [Citation(s) in RCA: 197] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The musculoskeletal fibromatoses comprise a wide range of lesions with a common histopathologic appearance. They can be divided into two major groups: superficial and deep. The superficial fibromatoses are typically small, slow-growing lesions and include palmar fibromatosis, plantar fibromatosis, juvenile aponeurotic fibroma, and infantile digital fibroma. The deep fibromatoses are commonly large, may grow rapidly, and are more aggressive. They include infantile myofibromatosis, fibromatosis colli, extraabdominal desmoid tumor, and aggressive infantile fibromatosis. Radiographs typically reveal a nonspecific soft-tissue mass, and calcification is common only in juvenile aponeurotic fibroma. Advanced imaging (ultrasonography, computed tomography, and magnetic resonance [MR] imaging) demonstrates lesion extent. Involvement of adjacent structures is common, reflecting the infiltrative growth pattern often seen in these lesions. MR imaging may show characteristic features of prominent low to intermediate signal intensity and bands of low signal intensity representing highly collagenized tissue. However, fibromatoses with less collagen and more cellularity may have nonspecific high signal intensity on T2-weighted images. Local recurrence is frequent after surgical resection due to the aggressive lesion growth. It is important for radiologists to recognize the imaging characteristics of musculoskeletal fibromatoses to help guide the often difficult and protracted therapy and management of these lesions.
Collapse
Affiliation(s)
- M R Robbin
- Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH 44106, USA.
| | | | | | | | | |
Collapse
|
21
|
Dalgiç N, Ergenekon E, Bideci A, Erbaş G, Koç E, Tali T, Atalay Y. Congenital retropharyngeal goiter in a newborn as a magnetic resonance imaging finding. Pediatr Int 2001; 43:431-3. [PMID: 11472595 DOI: 10.1046/j.1442-200x.2001.01403.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- N Dalgiç
- Department of Pediatrics, Gazi University Hospital, Ankara, Turkey
| | | | | | | | | | | | | |
Collapse
|
22
|
Cheng JC, Metreweli C, Chen TM, Tang S. Correlation of ultrasonographic imaging of congenital muscular torticollis with clinical assessment in infants. ULTRASOUND IN MEDICINE & BIOLOGY 2000; 26:1237-1241. [PMID: 11120359 DOI: 10.1016/s0301-5629(00)00301-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Congenital muscular torticollis (CMT) is a common problem affecting infants and children. There is a general lack of standard clinical classification or objective assessment methods. Ultrasonographic imaging of the sternomastoid muscle (SCM) has been carried out in a consecutive series of 436 infants less than 1 y old presenting with CMT over a 5-y period. All patients were classified into three clinical groups: postural torticollis, muscular torticollis and sternomastoid tumor. The severity of the torticollis was also expressed into four subgroups according to the degree of deficits in passive rotation of the neck. The ultrasonographic image of the affected SCM included the echogenicity, texture, motility, softness and the transverse and longitudinal extent of the involvement. The disturbance in the quantitative measurement of the transverse diameter of the lower and upper third of the SCM and the ratio of the measurement to the normal side was recorded. The qualitative and quantitative changes in the SCM image were found to correlate significantly with the clinical typing and severity of rotational deficits of the neck. Ultrasonographic imaging has important potential clinical application in helping the diagnosis, prognostication and monitoring of progress of CMT longitudinally.
Collapse
Affiliation(s)
- J C Cheng
- Departments of Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.
| | | | | | | |
Collapse
|
23
|
Abstract
BACKGROUND AND AIMS Thyroglossal duct cysts (TDC) in children have a variable sonographic appearance. Some reports have suggested that TDCs appear on ultrasound as well defined, cystic masses with thin walls and posterior enhancement, whereas others have documented a heterogeneous echopattern within these lesions. In our experience, although TDCs in children have a variable ultrasound appearance, the most common appearance is that of a pseudosolid mass closely related to the hyoid bone. In this study we report on 23 patients with thyroglossal duct cysts and document the ultrasonic patterns. PATIENTS AND METHODS All patients in whom the diagnosis of TDC was made clinically (by at least two head and neck surgeons) and in whom ultrasound detected a cystic mass related to the hyoid bone, were included in this study. Sonograms of 23 children with TDCs were reviewed. The features evaluated included their location, internal echogenicity, posterior enhancement, the presence of septa, a solid component and a fistulous tract. The echopattern was not correlated with the biopsy results. RESULTS Three patterns of TDCs were identified: anechoic (13%); pseudosolid (56.5%); and a heterogeneous pattern (30.5%). The majority were midline (82.6%), showed posterior enhancement (56.5%), and had thin walls (82.6%). CONCLUSION On ultrasound, TDCs in children are not simple cysts but have a complex pattern ranging from a typical anechoic cyst to a pseudosolid appearance (most common).Ahuja, A. T. (2000). Clinical Radiology55, 770-774.
Collapse
Affiliation(s)
- A T Ahuja
- Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong.
| | | | | |
Collapse
|
24
|
Abstract
The sternocleidomastoid tumor of infancy (STOI) is a relatively uncommon condition. Typically, it presents as a firm, well circumscribed mass within the sternocleidomastoid muscle (SCM) in infants 1-8 weeks of age and may be associated with torticollis. This condition must be considered in any infant with a lateral neck mass. The diagnosis can often be made clinically, but unusual presentations may present diagnostic challenges. Although bilateral involvement is rare, it does occur. The second reported case, a 2-week old female with bilateral STOIs and torticollis, is reported. Although many of the characteristics of the masses suggested the condition, the bilateral nature added uncertainty to the clinical impression, and magnetic resonance imaging (MRI) was used to confirm the diagnosis. The clinical presentation and management of the STOI are reviewed, and the unusual features of this case are discussed.
Collapse
Affiliation(s)
- R P Tufano
- Division of Otolaryngology, Children's Hospital of Philadelphia, Wood Center, PA 19104, USA
| | | | | |
Collapse
|
25
|
Goyal A, Tiwari RS, Desai AA. Diagnostic role of ultrasonography in neck swellings. Indian J Otolaryngol Head Neck Surg 1999; 51:67-71. [PMID: 23119577 PMCID: PMC3451384 DOI: 10.1007/bf03022722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Diagnostic Role of Ultrasonography in Neck Swellings The study of ultrasonographic features of various neck swellings in fifty patients was done. There were 22 thyroid and thyroid related swelling, 8 salivary gland lesions, 9 lymph nodes and 14 swellings of miscellaneous origin. Various ultrasonographic features like echogenicity, echotextures were noted. There were no specific echogenicity in benign and malignant thyroid neoplasms. Various ultrasonographic features of benign and malignant salivary neoplasms and lymph nodes are described. Specific sonographic features of various miscellaneous neck swellings are also described.
Collapse
Affiliation(s)
- A Goyal
- Government Medical College Hospital, Sector 32, Chandigarh
| | | | | |
Collapse
|
26
|
Abstract
Facial asymmetry secondary to pathologic processes involving the maxillary sinus and its surrounding structures presents a challenge for the clinician. An organized approach to evaluate these patients is essential in order to differentiate inflammatory sinus pathology from disease processes primarily involving the surrounding maxilla, parotid gland, orbital contents, and dental structures. In addition to a thorough history and physical examination, appropriate imaging studies must be obtained to localize the pathologic processes and develop a meaningful differential diagnosis. Once this is accomplished, specific treatment modalities can be developed. Representative cases will be presented to illustrate this organized approach to unilateral maxillary swelling, including soft tissue and osseous masses, fibro-osseous lesions, osseous cysts and inflammatory lesions.
Collapse
Affiliation(s)
- B L Koch
- Department of Radiology, Children's Hospital Medical Center and the University of Cincinnati College of Medicine, OH 45229-3039, USA
| | | |
Collapse
|
27
|
Bedi DG, John SD, Swischuk LE. Fibromatosis colli of infancy: variability of sonographic appearance. JOURNAL OF CLINICAL ULTRASOUND : JCU 1998; 26:345-348. [PMID: 9719983 DOI: 10.1002/(sici)1097-0096(199809)26:7<345::aid-jcu3>3.0.co;2-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
PURPOSE We describe the variable sonographic appearances of fibromatosis colli, a disease that presents as a mass-like enlargement of the sternocleidomastoid muscle during the first 8 weeks of life. METHODS Sonograms and records of 12 infants who presented with a sternocleidomastoid mass or torticollis before they were 12 weeks old were retrospectively reviewed for sonographic features (presence of a mass, diffuse muscle enlargement, and echogenicity), medical history, and follow-up data. RESULTS Sonographically, 6 infants had only a mass in the sternocleidomastoid muscle, 2 had a mass with fusiform muscle enlargement, and 4 had only muscle enlargement. Five masses were hyperechoic, and 1 mass was of mixed echogenicity. The 2 masses associated with muscle enlargement were hypoechoic. Three cases of diffuse muscle enlargement were of mixed echogenicity, and 1 was hypoechoic. Unusual variations included (1) a mass split longitudinally into 2 components and (2) a diffusely enlarged muscle with a striated pattern of mixed echogenicity. Follow-up in 10 patients at 4 months and in 7 patients at 6 months showed clinical improvement. CONCLUSION Fibromatosis colli usually appears sonographically as a hyperechoic mass or diffuse sternocleidomastoid enlargement of mixed echogenicity. Variations in its appearance should not prevent the correct diagnosis as long as the abnormality is intramuscular and adjacent soft tissues are normal.
Collapse
Affiliation(s)
- D G Bedi
- Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA
| | | | | |
Collapse
|
28
|
Lin JN, Chou ML. Ultrasonographic study of the sternocleidomastoid muscle in the management of congenital muscular torticollis. J Pediatr Surg 1997; 32:1648-51. [PMID: 9396548 DOI: 10.1016/s0022-3468(97)90475-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Congenital muscular torticollis (CMT) in infancy is caused by the fibrotic change of the sternocleidomastoid muscle (SCMM). The etiology and management strategies remain controversial. METHODS One hundred ninety-seven infants and children aged 1 month to 16 years who had CMT were examined by real-time ultrasonography of the SCMM between June 1995 and September 1996 in a prospective and longitudinal study. A total of 362 examinations were performed. There were 122 boys and 75 girls. RESULTS The right side was involved in 117 patients (59.3%), the left side in 79 patients (40.1%), and both sides in one patient. The sonographic findings were homogeneous or heterogeneous (patchy) hyperechoic lesion within the SCMM, and all were diagnostic. The ultrasonographic appearance of the SCMM in this study has a close resemblance to the clinical course of CMT. The extent of fibrosis as represented by the cross section of lesion to muscle ratio (L/M ratio) decreased from 83.6% at 2 months to 59.9% at 9 months of age and further decreased to 40% beyond 1 year of age. This consistent decrease in fibrosis was caused by the increased normal muscle volume at the periphery and by the regenerated muscle fibers within the lesion. In this series of 197 patients, 32 (16.2%) eventually underwent surgery to release the SCMM because of persistent head tilt, chin deviation and limited range of neck motion beyond 1 year of age. The L/M ratio of the operative group was 62.7 +/- 16.0% compared with an L/M ratio of 54.5 +/- 14.2% (P = .035) for the nonoperative group at 1 year of age. The extent of fibrotic change in the cross section of the muscle was a significant factor in determining prognosis. In the longitudinal section, the fibrotic change was limited to only the lower third of the SCMM in 27 patients, and all of them recovered without operation. In 95 patients, the fibrotic lesion was limited to the middle and lower third or middle third only, and only six (6.3%) underwent operation. However, in 75 cases the entire length of muscle was involved, and 26 (34.7%) required surgical release of the contracted muscle. Whole-length muscle involvement was also important for predicting recovery without operative intervention. CONCLUSIONS Ultrasonographic study of the SCMM is not only a valuable diagnostic tool but can also serve as a useful guideline for the treatment of infants who have congenital muscular torticollis.
Collapse
Affiliation(s)
- J N Lin
- Department of Pediatric Surgery, Chang Gung Children's Hospital and Chang Gung Medical College, Taipei, Taiwan
| | | |
Collapse
|
29
|
NECK MASSES IN INFANTS AND CHILDREN. Radiol Clin North Am 1997. [DOI: 10.1016/s0033-8389(22)00729-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
30
|
Abstract
We report the magnetic resonance imaging findings in a patient with fibromatosis colli, typically a self-limiting process that does not require therapeutic intervention. Familiarity with this condition and its appearance may prevent unnecessary invasive procedures.
Collapse
Affiliation(s)
- E L Snitzer
- Department of Radiology, University of Rochester Medical Center, New York 14642, USA
| | | | | |
Collapse
|
31
|
Abstract
Deep neck abscesses are serious complications of common upper respiratory tract infections in children. Children are especially prone to airway obstruction complicating deep neck abscess. Pediatricians must understand the presentations and treatment of deep neck abscesses to avoid potentially life-threatening complications.
Collapse
Affiliation(s)
- P J Nicklaus
- Department of Surgery-ENT, University of New Mexico Health Sciences Center, Albuquerque, USA
| | | |
Collapse
|
32
|
Josephson GD, de Blasi H, McCormick S, Sabini P, Goldberg J, Pincus R. Focal myositis of the sternocleidomastoid muscle: a case report and review of the literature. Am J Otolaryngol 1996; 17:215-7. [PMID: 8827284 DOI: 10.1016/s0196-0709(96)90064-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- G D Josephson
- Department of Otolaryngology, New York Eye and Ear Infirmary, New York 10003, USA
| | | | | | | | | | | |
Collapse
|
33
|
Youkilis RA, Koch B, Myer CM. Ultrasonographic imaging of sternocleidomastoid tumor of infancy. Ann Otol Rhinol Laryngol 1995; 104:323-5. [PMID: 7717626 DOI: 10.1177/000348949510400413] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- R A Youkilis
- Department of Radiology, Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA
| | | | | |
Collapse
|
34
|
Lundeen BE, Sty JR. Ectopic cervical thymus: a rare neck mass in an infant. JOURNAL OF CLINICAL ULTRASOUND : JCU 1994; 22:412-415. [PMID: 8071462 DOI: 10.1002/jcu.1870220611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- B E Lundeen
- Department of Radiology, Children's Hospital of Wisconsin, Milwaukee 53226
| | | |
Collapse
|
35
|
Abstract
The sonographic appearance of the sternocleidomastoid muscles of 36 children with congenital muscular torticollis was studied. Sternocleidomastoid tumour was detected in all of them and the images were more complex than described in the literature. A patchy echo-texture was as frequent as a homogeneous echo-texture, and was more common in the younger child. The echo-genicity of the mass could be hyperechoic, isoechoic or hypoechoic relative to normal muscle. A hypoechoic rim surrounding the mass was frequently present. Change of the proportion of the mass relative to the entire muscle-mass complex in different ages matching clinical observations was also noted. These sonographic findings would be important in establishing a sonographic diagnosis. The higher sensitivity of ultrasound in detection of sternocleidomastoid tumour over clinical methods, and the importance of the sonographic findings in the management of congenital muscular torticollis were also discussed.
Collapse
Affiliation(s)
- Y L Chan
- Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin, Hong Kong
| | | | | |
Collapse
|
36
|
|
37
|
Abstract
A case of mycotic carotid artery aneurysm due to cervical lymphadenitis in a four-year old child is presented. Sonography and computed tomography (CT) demonstrated an irregular fluid-containing neck mass, similar in appearance to an uncomplicated abscess. Continuity with the carotid artery was suggested on sonography, and CT demonstrated intense contrast enhancement of the liquid portion of the mass. Mycotic carotid artery aneurysm is a rare, but potentially fatal, complication of cervical lymphadenitis that is detectable with noninvasive diagnostic imaging studies.
Collapse
Affiliation(s)
- R G Wells
- Children's Hospital of Wisconsin, Milwaukee
| | | |
Collapse
|
38
|
Affiliation(s)
- R Salvador
- Department of Radiodiagnosis, Universidad Autónoma de Barcelona, Spain
| | | | | | | | | |
Collapse
|
39
|
Ben-Ami T, Yousefzadeh DK, Aramburo MJ. Pre-suppurative phase of retropharyngeal infection: contribution of ultrasonography in the diagnosis and treatment. Pediatr Radiol 1990; 21:23-6. [PMID: 2287534 DOI: 10.1007/bf02010808] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Pre-suppurative phase of retropharyngeal infection can't be differentiated from retropharyngeal abscess clinically or radiographically. Ultrasound, however, can diagnose this common infection in early phase. Early antibacterial treatment prevents the suppurative phase, obviates surgery and shortens the hospitalization phase.
Collapse
Affiliation(s)
- T Ben-Ami
- Department of Radiology and Pediatrics, Wyler Children's Hospital, University of Chicago, Illinois
| | | | | |
Collapse
|
40
|
Glasier CM, Seibert JJ, Williamson SL, Seibert RW, Corbitt SL, Rodgers AB, Lange TA. High resolution ultrasound characterization of soft tissue masses in children. Pediatr Radiol 1987; 17:233-7. [PMID: 3295732 DOI: 10.1007/bf02388167] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Forty-two soft tissue masses in infants and children were examined with high resolution ultrasonography. Sonography was diagnostically specific in 17/42 (40%), useful but not diagnostic in 24/42 (58%), and misleading in 1/42 (2%) of soft tissue masses. Lesions with diagnostic sonographic features included cystic hygroma, fibromatosis colli, lymphadenopathy with abscess formation, and one case of osteomyelitis.
Collapse
|