肺外支气管源性囊肿的CT和MRI表现及鉴别分析  

CT and MRI findings of extrapulmonary bronchogenic cyst and its differential analysis

作　　者：李晓冉 高志军 朱文莉 傅晓明 LI Xiaoran;GAO Zhijun;ZHU Wenli;FU Xiaoming(Department of Medical Imaging,Nanjing Gaochun People’s Hospital,Nanjing 211300,China)

机构地区：[1]南京市高淳人民医院医学影像科,江苏南京211300

出　　处：《实用放射学杂志》2024年第11期1792-1795,共4页Journal of Practical Radiology

摘　　要：目的探讨肺外支气管源性囊肿(BC)的分布特点和影像学表现并进行鉴别。方法收集经病理证实的32例肺外BC的患者资料,分析并总结病灶位置、CT和MRI表现。32例均行CT平扫检查,其中27例加行CT增强扫描检查,3例加行MRI平扫及增强检查。结果32例患者中,24例为纵隔型BC,发生于前纵隔20例、中纵隔0例、后纵隔4例;8例为异位型BC,发生于上胸壁2例,胃贲门4例,胃大弯1例,左侧肾上腺区1例。所有病灶均为单发、边界清晰;病灶主要呈类圆形(22例),少部分呈扁平状/“D”形(10例),纵隔型BC及异位型BC在纳入征象中的差异无统计学意义(P>0.05);2例囊壁出现结节状钙化;病灶平扫CT值<20 HU 4例,CT值≥20 HU 28例;27例行CT增强扫描均为无强化或轻度强化;MRI 2例T_(1)WI呈低信号,1例T_(1)WI呈等信号,3例T_(2)WI呈高信号,1例行T_(1)WI增强扫描表现为较明显强化。32例中30例(93.7%)误诊,误诊为胸腺囊肿8例,胸腺瘤12例,神经源性肿瘤4例,节细胞神经瘤4例,胃间质瘤2例。结论肺外BC较罕见,多分布在人体中轴线附近区域,病灶多无明显强化、少数可伴囊壁钙化等影像学特点,对辅助临床诊断具有一定的实用价值。Objective To investigate the distribution and imaging manifestations of extrapulmonary bronchogenic cyst(BC)and to make differential diagnosis.Methods The data of 32 patients with extrapulmonary BC confirmed by pathology were collected.The lesion location,CT and MRI findings were analyzed and summarized.All patients underwent plain CT scan,and 27 of them underwent enhanced CT scan.Three patients underwent MRI plain and enhanced scan.Results Of the 32 patients,24 cases were mediastinal BC including 20 cases in the anterior mediastinum and other 4 cases in the posterior mediastinum.8 cases were ectopic BC,including 2 cases in the upper chest wall,4 cases in the gastric cardia,1 case in the greater curvature of the stomach,and 1 case in the left adrenal gland.All lesions were single with clear boundary.The lesions were mainly round in shape(22 cases),and a few were flat/“D”shape(10 cases).There were no significant differences in the included signs between mediastinal BC and ectopic BC(P>0.05).Nodular calcification of cyst wall was found in 2 cases.There were 4 cases with CT value<20 HU and other 28 cases with CT value≥20 HU.The enhanced CT scan in 27 cases showed non-or mild enhancement.MRI showed hypointensity on T_(1)WI in 2 cases,isointensity on T_(1)WI in 1 case,hyperintensity on T_(2)WI in 3 cases,and obvious enhancement on T_(1)WI enhanced scan in 1 case.In addition,30 cases(93.7%)were misdiagnosed as thymic cyst(8 cases),thymoma(12 cases),neurogenic tumor(4 cases),ganglioneuroma(4 cases)and gastric stromal tumor(2 cases).Conclusion Extrapulmonary BC is rare,and most of the lesions are located near the central axis of the body with no obvious enhancement and sometimes cyst wall calcification,which has certain value for clinical diagnosis.

关 键 词：支气管源性囊肿 计算机体层成像 磁共振成像 

分 类 号：R562.2[医药卫生—呼吸系统] R814.42[医药卫生—内科学] R445.2[医药卫生—临床医学]