Pseudolesions of the head and neck （头颈部假性病变）

原文发表在Oral and Maxillofacial Surgery Clinics of North America上面¹，介绍了头颈部影像中的一些假性病变。其将pseudolesion定义为：

A pseudolesion is defined as a normal variant, imaging artifact, or foreign object that mimics a true pathologic condition.

1. ARRESTED PNEUMATIZATION OF THE SKULL BASE – 颅底气化停滞

Incomplete aeration of fatty marrow sites can result in persistent regions of fatty foci in the skull base.

Arrested skull base pneumatization appears as a non-expansile mixed-density lesion with sclerotic periphery in the midline basisphenoid/basiocciput region or adjacent skull base. The internal structure usually contains curvilinear calcifications. MRI typically shows high T1 signal due to fat content.

2. JUGULAR BULB PSEUDOMASS – 颈静脉球假性占位

3. TROCHLEAR CALCIFICATION – 眼眶滑车钙化

4. ASYMMETRIC ENHANCEMENT OF THE PTERYGOID PLEXUS – 翼丛静脉不对称性增强

出现在增强CT中.

5. RETROPHARYNGEAL CAROTID ARTERY – 咽后颈动脉

咽后颈动脉 并非一个独立的解剖结构，而是指颈动脉在咽部后方走行的一种解剖变异。正常情况下，颈动脉位于咽部侧方；当它异常地向内侧迂曲或走行于咽部正后方时，就形成了“咽后位”。在诊断以及一些如插管等临床操作中需要注意出血风险。

6. FACIAL FILLERS – 面部填充材料

略

7. ACCESSORY PAROTID GLAND – 副腮腺

略

8. MASSETERIC HYPERTROPHY – 咬肌肥大

9. COMESTIBLE INTRAORAL FOREIGN BODIES – 口内可食性异物

略

10. LINGUAL THYROID – 舌异位甲状腺

略

11. HYPOGLOSSAL MOTOR DENERVATION – 舌下神经运动纤维失神经支配

Damage to the hypoglossal nerve (CN XII) anywhere along its course may lead to denervation and subsequent muscle atrophy of the affected side of the tongue. On clinical examination, this may present with weakness and deviation of the tongue to the affected side.

Early changes include T2 hyperintensity, enlargement and enhancement of the affected hemitongue with mass effect and posterior protrusion into the oropharynx. Long-standing chronic denervation manifests as atrophy and fatty replacement of the affected hemitongue.

When hypoglossal nerve pathology is suspected, the next step is to determine whether the pathology is isolated to CN XII or involves additional lower cranial nerves to help localize the potential lesion.

12. UNILATERAL APLASIA OF THE SUBMANDIBULAR GLAND – 单侧颌下腺发育不全/先天性缺如

略

13. STAFNE BONE DEFECT – “静止性骨腔”

略

14. MYLOHYOID BOUTONNIERE

下颌舌骨肌的一种解剖变异，此前曾有过介绍：mylohyoid boutonnière

15. CALCIFIED TRITICEOUS CARTILAGE – 麦粒软骨钙化

The triticeous (triticeal or tritiate) cartilages are small, paired cartilages located within the lateral thyrohyoid ligaments. The cartilage is measuring 7 to 9 mm in length, 2 to 4 mm in width, and shaped like a grain of wheat. The cartilage often calcifies and may mimic a foreign body on plain films and CT. A calcified triticeous cartilage can be reliably identified by its perfectly uniform shape and size. Less frequently, a calcified arytenoid cartilage may be mistaken for a foreign body.

16. VOCAL CORD INJECTION

略

17. LEVATOR SCAPULAE MUSCLE HYPERTROPHY – 肩胛提肌肥大

Levator scapulae muscle hypertrophy may present as a neck mass on imaging, which can be misinterpreted as a tumor recurrence, especially in patients who have undergone a previous radical neck dissection in which the internal jugular vein, sternocleidomastoid muscle, and spinal accessory nerve were resected. This results in denervation atrophy of the ipsilateral trapezius muscle and subsequent compensatory hypertrophy of the ipsilateral levator scapulae muscle. This compensatory hypertrophy provides improved shoulder stabilization and elevation, thus preserving shoulder function.

18. PATIENT MOTION ARTIFACTS – 运动伪影

大部分这类伪影容易分辨，但是文章中提供的图片显示的这种伪影尚未遇见过。

1. Omami G, Arani K. Pseudolesions of the Head and Neck Region. Oral Maxillofac Surg Clin North Am. 2025 Oct 16:S1042-3699(25)00064-0. doi: 10.1016/j.coms.2025.08.014. Epub ahead of print. PMID: 41107089. ↩