摘要
目的探讨皮下表皮囊肿及其破裂后的多层螺旋CT(MSCT)表现,以提高其影像诊断水平。方法回顾性分析经手术病理证实的25例皮下表皮囊肿的MSCT表现及临床资料。男20例,女5例,年龄6~82岁,平均48.5岁。23例为单发病灶,2例为双发病灶。结果25例患者共27个病灶,病灶位置分布于颌面部(10个),耳廓(2个),头皮(3个),颈部(2个),胸背部和腹背部(5个),骶尾部(1个),臀部(4个)。17个病灶呈低密度,1个呈等密度,9个呈混杂密度。8个内有分隔。增强扫描后17个病灶呈薄壁光滑型强化,10个呈厚壁不规则型强化;8个病灶周围软组织可见小片状强化。组织病理检查,19个病灶为未破裂型,8个为破裂型。统计学分析显示,平扫密度在两型中无显著的统计学差异(P>0.01);而分隔、囊壁强化形态以及周围软组织片状强化三种MSCT征象在两型中具有显著的统计学差异(P<0.01)。结论未破裂型皮下表皮囊肿囊内多无分隔,增强扫描囊壁呈薄壁光滑型强化,周围软组织多无明显强化;破裂型皮下表皮囊肿囊内可见到分隔,增强扫描囊壁呈厚壁不规则型强化,邻近软组织可见到片状强化。
Objective To explore the MSCT findings of the subcutaneous epidermal cysts with or without rupture and to improve its diagnostic level.Methods The clinical data and MSCT findings of 25 patients with pathologically proved subcutaneous epidermal cysts were retrospectively analyzed.The patients were 6-82 years old(average age,48.5 years).These 25 patients included 20 men and 5 women.Twenty-three lesions were solitary and 2 cases presented with double lesions.Results A total of 27 lesions were found in the 25 patients.The locations of the 27 lesions were as follows:face(n=10),auricle(n=2),Scalp(n=3),neck(n=2),chest and abdomen(n=5),lumbosacral portion(n=1),and buttock(n=4).On unenhanced CT scans,seventeen lesions of hypodensity,1 lesion of isodensity,and 9 lesions of mixed density.Eight of the 27 lesions had septa.On enhanced CT scans,Seventeen lesions of thin and smooth wall enhancement,ten lesions of thick and irregular wall enhancement.Eight of the 27 lesions showed patchy fuzzy enhancement in surrounding subcutaneous tissue.Histopathologically,nineteen lesions were unruptured and 8 lesions were ruptured.There was no statistically significant difference between the attenuation of the unruptured subcutaneous epidermal cysts and the ruptured subcutaneous epidermal cysts(P>0.01).A significant difference between septation,enhanced rim shapes,and surrounding soft tissue enhancement was observed between the two types of epidermal cysts(P<0.01).Conclusion The unruptured subcutaneous epidermal cysts almost have no septa,and show thin and smooth wall enhancement,have no surrounding soft tissue enhancement.The ruptured subcutaneous epidermal cysts almost have variable septa,and appear thick and irregular peripheral rim enhancement,surrounding soft tissue enhancement.
作者
方字文
余水全
刘树学
FANG Ziwen;YU Shuiquan;LIU Shuxue(Department of Radiology,Hospital of Traditional Medicine of Zhongshan,Zhongshan,Guangdong Province 528400,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第9期1827-1831,共5页
Journal of Clinical Radiology
