摘要
目的:分析并总结纵隔支气管囊肿的CT影像表现,并对误诊病例进行分析,提高该病诊断正确率。方法:回顾性分析经手术后病理证实的16例患者的CT影像特征,包括病灶的位置、形态、大小、同周围结构关系、平扫CT值及增强扫描后CT值变化。结果:本组16例囊肿,其中前纵隔4例,1例位于左前纵隔,3例位于胸骨后正中纵隔;中纵隔7例(4例位于左侧,3例位于右侧);后纵隔5例,均位于左侧。15例病灶形态较规则,均呈圆形或卵圆形;1例呈三角形。6例囊肿最大径>50mm,另外10例最大径均<50mm。6例压迫邻近气管、食管、肺动脉或上腔静脉。3例患者未行平扫,在进行平扫的13例病灶中,9例平扫CT值>30Hu。16例患者均行增强扫描,增强扫描2例囊壁略增厚(>3mm)强化;2例CT值较平扫增加>10Hu,其余14例均未见明显强化。16例病灶8例诊断正确,8例误诊,其中4例误诊为神经源性肿瘤,3例误诊为胸腺瘤,1例误诊为淋巴管瘤。结论:纵隔支气管囊肿CT影像表现具有一定的特点,当发现中纵隔或前纵隔、左后纵隔均匀密度肿块,边界清晰,增强扫描无强化,应考虑到该病可能。
Objective:To analyze and summarize the CT imaging manifestations of mediastinal bronchogenic cysts, and the misdiagnosed cases were analyzed to improve the accuracy of the diagnosis. Methods:The CT image characteristics of 16 patients confirmed by postoperative pathology were retrospectively analyzed, including the location, shape, size, relationship with surrounding structures, and CT value of plain scan and that of enhanced scan of the lesion. Results:There were 16 cases of bronchogenic cysts in this study, including 4 cases in the anterior mediastinum(1 case in the left anterior mediastinum, and 3 cases posterior to the sternum), 7 cases in the middle mediastinum(4 cases were on the left and 3 cases on the right), and 5 cases in the left posterior mediastinum. The lesions in 15 cases were regularly shaped, with round or oval shape;1 case was triangular shaped. The maximum diameter of the cyst was> 50 mm in 6 cases, and in other cases the maximum diameter was <50 mm. Bronchogenic cysts in 6 cases compressed the adjacent trachea, esophagus, pulmonary artery or superior vena cava. 13 patients underwent CT plain scan, with 9 lesions showed CT values >30 Hu. All 16 patients underwent enhanced CT scan. Two lesions demonstrated thickening(> 3 mm) and enhancement of the cyst wall. The CT values of two lesions increased by more than 10 Hu compared with plain CT scan, and the other 14 lesions showed no significant enhancement. Of the 16 cases, 8 cases were diagnosed correctly, the other 8 cases were misdiagnosed, 4 of which were misdiagnosed as neurogenic tumors, 3 cases were misdiagnosed as thymoma, and 1 case was misdiagnosed as lymphangioma. Conclusion:The CT image of mediastinal bronchogenic cyst has certain characteristics. If a homogenous mass with clear boundary was found in the middle mediastinum, or anterior mediastinum and left posterior mediastinum, and showed no enhancement in the enhanced CT image, the possibility of the mediastinal bronchogenic cyst should be considered.
作者
王骏
李芳云
梁羡和
高瑞晖
Wang Jun;Li Fangyun;Liang Xianhe;Gao Ruihui(Department of Radiology,Zhongshan Torch Development Zone Hospital,Zhongshan,Guangdong 528437;Department of Radiolooy,Zhongshan Peoplee Hospital,Zhongshan,Guangdong 528400)
出处
《现代医用影像学》
2020年第8期1429-1432,共4页
Modern Medical Imageology
