易误诊的纵隔型支气管源性囊肿的临床及影像特点  

Clinical and Imaging Characteristics Of Easily Misdiagnosed Mediastinal Bronchogenic Cysts

作　　者：李姝琪 李杰[1] 范璐[1] 孙玮[1] 孟令思 楚阿兰 杨宏星 刘迎 LI Shu-qi;LI Jie;FAN Lu;SUN Wei;MENG Ling-si;CHU A-lan;YANG Hong-xing;LIU Ying(Department of Medical Imaging,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,Henan Province,China;Cancer Diagnostics,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,Henan Province,China;Department of General Surgery,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,Henan Province,China;Department of Breast Surgery,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,Henan Province,China)

机构地区：[1]郑州大学第二附属医院医学影像科,河南郑州450014 [2]郑州大学第二附属医院肿瘤诊断学,河南郑州450014 [3]郑州大学第三附属医院普外科,河南郑州450014 [4]郑州大学第三附属医院乳腺外科,河南郑州450014

出　　处：《中国CT和MRI杂志》2024年第9期64-66,共3页Chinese Journal of CT and MRI

基　　金：2022年度河南省医学科技攻关计划软科学项目(LHCJ20220487)。

摘　　要：目的通过分析纵隔型支气管源性囊肿(mediastinal bronchogenic cyst,MBC)的临床及影像学特征,以期降低误诊率、提高其临床诊断率。方法收集在郑州大学第二附属医院经胸腔镜手术切除并病理证实的MBC 27例患者临床及影像资料,其中术前22例被误诊,分析这22例被误诊病患的临床资料及影像表现,据此归纳其影像特征及误诊原因。结果27例术前确诊率为18.5%,误诊22例,误诊率为81.5%,其中前纵隔病变20例(占比74.1%),6例误诊为胸腺瘤,4例考虑淋巴结,误认为心包囊肿及胸腺囊肿各2例,囊性畸胎瘤1例,中纵隔病变2例(7.4%),均误诊为平滑肌瘤,后纵隔病变5例(18.5%),误诊为神经源性肿瘤3例、食管囊肿及食管平滑肌瘤各1例。27例全部为单发病例,其中液性密度8例,CT值范围约-3-12HU,平均13HU;19例为软组织密度影,CT值范围约23-73HU,平均41HU。结论将纵隔型支气管源性囊肿的临床表现和影像特征进行综合分析,可有效降低误诊率,提高临床诊断和鉴别诊断的准确率,对临床医生做出正确诊断有重要的指导意义。Objective By analyzing the clinical and imaging features of mediastinal bronchogenic cysts,we hope to reduce the misdiagnosis rate and improve the clinical diagnosis rate.Methods Clinical and imaging data of 27 patients with MBC confirmed pathologically by thoracoscopic resection were collected in the Second Affiliated Hospital of Zhengzhou University.Among them,22 cases were misdiagnosed before surgery.The clinical data and imaging findings of these 22 cases were analyzed,and the imaging characteristics and causes of misdiagnosis were summarized accordingly.Results The preoperative diagnosis rate of 27 cases was 18.5%,and the misdiagnosis rate of 22 cases was 81.5%.Among them,20 cases(74.1%)of anterior mediastinal lesions were misdiagnosed as thymoma,6 cases were misdiagnosed as thymoma,4 cases were misdiagnosed as pericardial cyst and thymoma cyst after considering lymph nodes,2 cases were mistaken for pericardial cyst and thymoma cyst,1 case of cystic teratoma,and 2 cases of mediastinal lesions(7.4%),all of which were misdiagnosed as leiomyoma.In 5 cases(18.5%),the posterior mediastinal lesions were misdiagnosed as neurogenic tumors in 3 cases,esophageal cysts in 1 case and esophageal leiomyoma in 1 case.All 27 cases were single cases,among which 8 cases had fluid density with CT values ranging from-3-12Hu with an average of 13Hu,and 19 cases had soft tissue density with CT values ranging from 23-73Hu with an average of 41Hu.Conclusion Comprehensive analysis of clinical manifestations and imaging features of mediastinal bronchogenic cysts can effectively reduce the misdiagnosis rate,improve the accuracy of clinical diagnosis and differential diagnosis,and have important guiding significance for clinicians to make correct diagnosis.

关 键 词：纵隔型支气管源性囊肿 易误诊 临床 影像特点 

分 类 号：R562.2[医药卫生—呼吸系统]