ลักษณะภาพรังสีส่วนตัดอาศัยคอมพิวเตอร์ในภาวะพังผืดอักเสบชนิดมีการตายเฉพาะส่วนบริเวณลำคอและใบหน้า

Abstract

Objective: To describe clinical features and characteristic CT findings of cervicofacial necrotizing fasciitis. Materials and Methods: A descriptive retrospective study of clinical features and MDCT findings (8 contrast-enhanced MDCT and 2 non-contrast enhanced MDCT) of 10 patients (6 men, 4 women; mean age 55.2 years; range 40-69 years) intra-operatively proven cervicofacial necrotizing fasciitis were reviewed. The CT features were analysed for diffuse skin thickening, subcutaneous fat reticulation, abnormal thickening, enhancement and loss part of cervical fasciae, abnormal enhancement and loss part of cervical muscles, fluid collections in cervical spaces, gas collections and mediastinal involvement. Results: All of the patients (10/10) showed loss part of cervical muscle and subcutaneous fat reticulations. Almost patients revealed diffuse skin thickening (6/10), abnormal thickening of the cervical fasciae (7/10) and multiple fluid collections in the cervical spaces (8/10). Loss part of the cervical fasciae and gas collections were visualised in three patients (3/10). Abnormal enhancement of the cervical fasciae was identified in two patients (2/8). Four patients off of eight patients (4/8) showed abnormal enhancement of the cervical muscles. Five patients (5/9) had feature of mediastinal involvement. Conclusion: MDCT could help to suggest diagnosis of cervicofacial necrotizing fasciitis by several findings such as loss part of cervical muscle, subcutaneous fat reticulations, diffuse skin thickening, abnormal thickening of the cervical fasciae and multiple fluid collections in the cervical spaces Keywords: Necrotizing fasciitis, head and neck, CT findings