Abstract
Background. Visualization of thyroglossal duct cysts and branchial cleft cysts at the preoperative stage of examination is important for planning the tactics and scope of surgical intervention. Purpose. To evaluate the diagnostic effectiveness of magnetic resonance imaging and computed tomography in identifying the distinctive features of thyroglossal duct cyst and branchial cleft cyst. Materials and methods. The study included data from 34 patients hospitalized in the clinic of maxillofacial surgery of the First Pavlov State Medical University of St. Petersburg with a preliminary diagnosis of a thyroglossal duct cyst or branchial cleft cyst for surgical treatment, among whom there were 23 women and 11 men. At the first stage, the patient’s complaints, the results of a physical examination were assessed, and anamnesis data studied. On the second stage we used radiological methods: computed tomography (CT) supplemented with contrast enhancement, contrast injection in the cystic cavity, and magnetic resonance imaging (MRI). At the stage of choosing treatment tactics, data from puncture biopsy and cytological examination of the punctate were analyzed. Statistical processing of data was carried out using the following techniques: Shapiro-Wilk W test, Student’s t test, Fisher’s test, in cyst size using Welch’s t test due to unequal variances when Levene’s test was used. Results. As a result of our study, among 34 (n=34; 100%) patients hospitalized with suspected сystic masses of neck, our study identified 23 (n=23; 67,6%) cases with thyroglossal duct cysts and 11 (n=11; 32,4%) with branchial cleft cysts. According to CT and MRI studies, the contents of the visualized formations corresponded to the cystic component obtained as a result of a puncture biopsy. CT visualized homogeneous formations with an X-ray density indicator corresponding to cystic (fluid) contents (10–25 HU); MRI showed high signal intensity on T2-weighted images; signal intensity on T1-weighted images depends on the protein content or hemorrhagic component. After intravenous contrast enhancement (both CT and MRI), in some cases, intense enhancement of the cyst wall was observed, which indicates infection of the cyst. Conclusions. The combined analysis of the obtained MRI and CT results makes it possible to adequately plan surgical intervention, leading to a decrease in the number of complications and relapses.