肺外支气管囊肿的影像诊断与误诊分析  

Imaging diagnosis and misdiagnosis analysis of extrapulmonary bronchial cyst

作　　者：陈光文[1] 李杭[1] 钱蓉 CHEN Guangwen;LI Hang;QIAN Rong(Department of Radiology,Sichuan Academy of Medical Sciences·Sichuan Provincial People’s Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院放射科,四川成都610072

出　　处：《实用放射学杂志》2021年第7期1077-1080,1085,共5页Journal of Practical Radiology

摘　　要：目的 探讨发生在肺外的支气管囊肿(BC)的影像表现特征并分析误诊原因.方法 66例经手术病理证实、发生在肺外的BC患者纳入研究,回顾性分析其影像学资料(63例CT和3例MRI)及导致误诊的原因.结果 纵隔型支气管囊肿(MBC)54例,前、中、后纵隔分别为27例、11例和16例;异位型支气管囊肿(EBC)12例,分别为颈部5例、胸壁1例、腹部6例.MBC中,3 cm以下29例,3 cm及以上25例;多数为圆形或椭圆形(49例),少数呈锥形(2例)或不规则形(3例);7例为液性密度,44例为软组织密度,2例呈T1低T2高信号、1例双高信号;8例伴有钙化.EBC中,3 cm以下4例,3 cm及以上8例;多数为圆形或椭圆形(9例),少数呈锥形(1例)、葫芦形(1例)和不规则形(1例);3例为液性密度,9例为软组织密度,3例伴有钙化.MBC中,8例(1例前纵隔、4例中纵隔和3例后纵隔)诊断准确,其余被误诊为心包囊肿(2例)、神经鞘囊肿(1例)、胸腺瘤(20例)、淋巴结肿大(5例)、神经源性肿瘤(12例)、平滑肌瘤(3例)、炎性假瘤(1例)和硬化性血管瘤(1例).EBC全部误诊,包括神经源性肿瘤(6例)、淋巴管囊肿(3例)、甲状舌骨囊肿(1例)、甲状腺囊肿(1例)和间质瘤(1例).结论 肺外BC的影像表现与其他囊、实性病变相似,以实性表现为主.缺乏特征性影像表现是导致误诊的主要原因.Objective To investigate the imaging features of extrapulmonary bronchial cysts(BC)and analyze the causes of misdiagnosis.Methods Sixty-six cases of extrapulmonary BC confirmed by surgical pathology were included in the study.The imaging data(63 CT and 3 MRI)and the causes of misdiagnosis were analyzed retrospectively.Results There were 54 cases of mediastinal bronchial cysts(MBC),in which 27 cases of anterior mediastinum,11 cases of middle mediastinum and 16 cases of posterior mediastinum were found.There were 12 cases of ectopic bronchial cyst(EBC),including 5 cases of neck,1 case of chest wall and 6 cases of abdomen.In MBC,the diameters below and above 3 cm were 29 cases and 25 cases respectively,and in terms of shape,49 cases were round or oval,2 cases were conical and 3 cases were irregular.Fluid density was observed in 7 cases,soft tissue density in 44 cases,T1 low T2 high signal intensity in 2 cases,double high signal intensity in 1 case and 8 cases were associated with calcification.In EBC,the diameters below and above 3 cm were 4 cases and 8 cases respectively.There were 9 cases of circular or oval shape.Conical,gourd and irregular shape were found 1 case each.Fluid density,soft tissue density and calcification were observed in 3,9,and 3 cases,respectively.In MBC,8 cases located in anterior mediastinum(1 case),middle mediastinum(4 cases)and posterior mediastinum(3 cases)were diagnosed as bronchial cyst,and the other were misdiagnosed as pericardial cyst(2 cases),nerve sheath cyst(1 case),thymoma(20 cases),lymph node enlargement(5 cases).neurogenic tumor(12 cases),leiomyoma(3 cases),inflammatory pseudotumor(1 case)and sclerosing hemangioma(1 case).In EBC,all cases were disdiagnosed,including neurogenic tumor(6 cases),lymphangiocyst(3 cases),and thyrohyoid cyst,thyroid cyst and stromal tumor 1 case each.Conclusion The imaging manifestations of extrapulmonary BC are similar to other cystic and solid lesions,and the solid manifestations are the main.The lack of characteristic imaging manifestaions is the mai

关 键 词：支气管囊肿 计算机体层成像 磁共振成像 病理学 

分 类 号：R562.2[医药卫生—呼吸系统] R814.42[医药卫生—内科学]