纤维素性纵隔炎影像特点分析  

Analysis of imaging characteristics of sclerosing mediastinitis

作　　者：李召侠 马展鸿[2] 蒋涛[2] LI Zhaoxia;MA Zhanhong;JIANG Tao(Department of Medical Image, Beijing Huairou Hospital of Chaoyang Hospital, Copital Medical Universty, Beijing 101400, China;Department of Medical Image, Beijing Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China)

机构地区：[1]首都医科大学附属,北京朝阳医院怀柔医院影像科,北京101400 [2]首都医科大学附属,北京朝阳医院影像介入中心,北京100020

出　　处：《医学影像学杂志》2022年第6期940-943,共4页Journal of Medical Imaging

摘　　要：目的探讨纤维素性纵隔炎的CT、MRI影像特点,探讨影像学检查在纤维素性纵隔炎临床诊疗中的作用,提高影像科医师对纤维素性纵隔炎疾病的认识,减少漏诊和误诊。方法选取48例纤维素性纵隔炎CT、MRI增强表现,包括病灶分布、密度及强化特点,对气管和支气管、动静脉血管的累及情况进行分析观察。结果48例纤维素性纵隔炎中,男性17例,占35.4%,女性31例,占64.6%,男女间发生率差异无统计学意义(P>0.05)。在所有患者中,合并肺动脉狭窄45例,占93.8%,合并肺静脉狭窄35例,占72.9%,合并支气管狭窄33例,占68.8%,12例患者进行了MRI检查,均可见纵隔内明显延迟强化病灶。结论纤维素性纵隔炎属于临床少见病,部分患者可能合并肺动静脉及支气管的狭窄,导致较重的临床症状,个别患者预后较差。CTPA检查能够较快、较准确地诊断纤维素性纵隔炎,并评估其病变范围及合并症,对临床早期诊断治疗具有重要价值。MRI增强检查可以辅助诊断纵隔炎性疾病,并可较准确地评估患者右心功能状态。Objective To analyze and study the CT and MRI features of fibrosing mediastinitis,to explore the role of imaging examination in the clinical diagnosis and treatment of fibrosing mediastinitis,to improve the understanding of imaging physicians on fibrosing mediastinitis,and to reduce misdiagnosis and missed diagnosis.Methods The CT and MRI images of 48 cases of fibro mediastinitis were analyzed retrospectively,interms of the distribution,density and enhancement characteristics of the focus,and the involvement of the trachea,bronchi and arteriovenous vessels.Results Of the 48 cases,17 were male,accounting for 35.4%,31 were female,accounting for 64.6%.There was no significant difference in the incidence between men and women(P>0.05).In all cases,24 cases were complicated with pulmonary artery stenosis,accounting for 55%,24 cases with pulmonary vein filling defect,accounting for 40%,21 cases with bronchial stenosis,accounting for 23%.MRI was performed in 12 cases,and obvious delayed enhancement focus was found in mediastinum,and the scope of focus was roughly the same as that of CT.Conclusion Cellulose mediastinitis is a rare clinical disease.Some patients may be complicated with pulmonary motility and bronchostenosis,resulting in severe clinical symptoms,and the prognosis of some cases is poor.CTPA examination can diagnose fibrosing mediastinitis quickly and accurately,and evaluate its pathological scope and complications,which is of great value for early diagnosis and treatment.Enhanced MRI can assist in the diagnosis of inflammatory diseases of mediastinum and accurately evaluate the right heart function of patients.

关 键 词：纤维素性纵隔炎 硬化性纵隔炎 纵隔炎 肺动脉造影 肺动脉外压性狭窄 体层摄影术 X线计算机 磁共振成像 

分 类 号：R564[医药卫生—呼吸系统] R445[医药卫生—内科学]