先天性支气管囊肿的影像诊断  

Imaging diagnosis of congenital bronchial cyst

作　　者：陈爱萍[1] 王德杭[1] 俞同福[1] 

机构地区：[1]南京医科大学第一附属医院放射科,南京210029

出　　处：《放射学实践》2016年第5期397-401,共5页Radiologic Practice

基　　金：江苏高校优势学科建设工程资助项目(JX10231801)

摘　　要：目的:探讨先天性支气管囊肿的影像学表现特征。方法:回顾性分析24例经手术病理证实的先天性支气管囊肿的CT和MRI图像。18例行CT增强扫描,6例行CT平扫,其中5例加行MRI平扫,2例行PET-CT扫描。结果:24例先天性支气管囊肿包括肺内型5例和纵隔型19例。病灶呈圆形、椭圆形、"D"字形或分叶形;11例病变位于典型部位,包括右侧气管7例和隆突下4例;13例病变位于不典型部位,包括前纵隔4例、食管旁2例、脊柱旁1例、心包旁1例和两下肺5例。以CT值20HU为囊、实性病变分界值,5例为囊性(CT值<20HU),19例为实性(CT值>20HU);边缘钙化3例;内部分层4例。病变T1WI呈低、等或高信号,T2WI均呈显著高信号,3例显示分层。24例中误诊10例,术前诊断符合率为58.3%。结论:先天性支气管囊肿的CT和MRI表现特征有助于其诊断和鉴别诊断,并指导进一步的治疗。[Abstract] Objective.. To study the imaging features of congenital bronchial cyst. Methods.. The clinical, CT and MRI materials of 24 patients with surgery and pathology proved congenital bronchial cysts were retrospectively analyzed. 18 pa- tients underwent pre- and post-contrast CT scanning and 6 patients only had plain CT. 5 patients had additional MRI and 2 patients had PET-CT. Results.. Of the 24 patients, there were intrapulmonary bronchogenic cysts （5 patients） and mediasti- nal bronchogenic cysts （19 patients）. Bronchogenic cysts can demonstrate as round,ovoid,＂D＂ shape and lobulated lesions. 11 lesions located at ＂typical position＂ including right side of trachea （7 cases） and infra-carina （4 cases）. 13 lesions located at ＂atypical position＂ including^anterior mediastinum （4 cases） ,para-esophagus （2 cases） ,para-spinal （1 case） para-pericar- dium （1 case） and the lower lobe of lung （5 cases）. Taking 20HU as the threshold deferentiating cystic and solid density, there were 5 lesions having cystic density and 19 lesions showed solid density. Marginal calcification was found in 3 lesions and fluid to fluid level was found in 4 lesions. On MRI, the cysts were iso- or hypo-intensity on T~ WI and hyperintensity on T2 WI. 10 of the 24 patients were misdiagnosed before surgery,the diagnosis accuracy was 58. 3~. Conclusion.. There were certain imaging characteristics of congenital bronchial cyst,which were valuable for diagnosis and guidance of treatment. [Key words] Bronchogenic cyst; Mediastinum~ Lung~ Tomography,X-ray computed~ Magnetic resonance imaging

关 键 词：支气管囊肿 纵隔 肺 体层摄影术 X线计算机 磁共振成像 

分 类 号：R655.3[医药卫生—外科学] R816.4[医药卫生—临床医学] R445.2