摘要
目的分析纵隔囊肿的影像学特点,提高对不同类型囊肿不典型表现的认识和诊断水平。方法回顾性分析经手术病理证实的44例纵隔囊肿的CT和(或)MRI资料(其中28和26例分别行CT和MR检查,10例同时行CT和MR检查),分析其影像学表现。结果囊肿位于前、中、后纵隔者分别为13、18和11例,位于前中纵隔者2例。支气管囊肿和心包囊肿位于不典型部位者分别为7和5例。CT密度近似于水者12例,占42.9%(12/28)。MR T2WI病变均为等或高于脑脊液的长T2信号,1例水成像上信号有衰减。近似于脑脊液的长T1信号者8例,占30.8%(8/26)。MRI信号不均匀者5例,原因各异。误诊14例。结论后纵隔和前纵隔CT高密度和厚壁的囊肿易被误诊为肿瘤性病变;中纵隔气管旁的心包囊肿易被误诊为支气管囊肿。MRI有助于诊断CT高密度的纵隔囊肿。MRI信号不均匀或水成像上信号衰减是误诊的原因。
Objective To characterize the imaging features of mediastinal cysts and gain a better understanding of atypical manifestations of various mediastinal cysts and improve the level of diagnosis. Methods The CT and/or MR images（ CT n = 28, MRI n = 26, CT and MRI n = 10）, surgical information, and pathologic material in 44 histopathologically proved cases of mediastinal cyst were retrospectively reviewed. Results The mediastinal cysts were located in the anterior mediastinum （ n = 13 ） , middle mediastinum（n = 18）, anterior-middle mediastinum （n = 2） and posterior mediastinum （n = 11 ）. Bronchogenic cysts and pericardial cysts were atypically located in 7/20 （35%）and 5/6 respectively. The density of 42. 9% cysts on CT was close to that of water. Each of the cysts had a high signal intensity that was equal to or greater than cerebrospinal fluid on T2-weighted MR images. One cyst showed marked loss of signal on MR hydrography. The signal intensities of the cysts were variable on T1 -weighted images. The signal intensity of MRI was not homogeneous in 5 and the reasons were different. Fourteen cases were misdiagnosed. Conclusion 1. The cysts with soft-tissue attenuation on CT in the anterior and posterior mediastinum may be easily misdiagnosed as neoplasm. Pericardial cysts located in the paratrachea may be easily misdiagnosed as bronchogenic cysts. 2. MRI can be used to diagnose the cysts with high density on CT. 3. Heterogeneous signal on MRI and loss of signal on MR hydrography might be the reasons for misdiagnosis.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2005年第10期1055-1059,共5页
Chinese Journal of Radiology
