高位心包上隐窝CT表现与意义

The high-located superior pericardial recess:CT findings and clinical significance

目的熟悉高位心包上隐窝的CT表现及其对诊断与鉴别诊断的意义。方法前瞻性对连续800例进行胸部螺旋CT检查的患者的CT图像进行观察,对明确或怀疑有高位心包上隐窝者进行1.25mm薄层重建和多平面重建,经2名有经验的医师最后确认,统计高位心包上隐窝的出现率,描述其表现并测量其大小。结果①19例最后被确认为高位心包上隐窝,占2.4%。在横轴位上表现为右侧气管旁区圆形、卵圆形、半月形、三角形或铸型灌注状水样密度结构,冠、矢状位呈长条带状,上部盲端呈囊袋状,往下紧贴无名动脉和升主动脉且与常见部位心包上隐窝相连。②大小:横轴位,平均长径和短径分别为19mm和14mm;矢状位或冠状位最长径平均56mm。结论CT薄层和多平面重建可更好地观察高位心包上隐窝,从而更有把握地与纵隔病变相鉴别。

Objective To clarify the CT features and clinical significance of the high-located superior pericardial recess （HSPR）. Methods Eight hundreds consecutive chest spiral CT scans were prospectively evaluated and the imaging of those suspected with HSPR were reconstructed with 1. 25 mm thin-section and performed with multiplanar reformations. The prevalence and appearance of HSPR were determined. Results O Nineteen cases （2. 4%） were determined with HSPR, which manifested in the right paratracheal region as a triangular, round, oval or semilunar structure or was molded by adjacent structure in axial images, as a long band-like structure along the lateral wall of right hrachiocephalic artery, the ascending aorta with a upper sac-like blind end in coronal and sagittal reformations, and which was contiguous with the superior pericardial recess on caudal images. （~Size： the average diameter of the short-axis and long-axis of HSPR was 14 mm and 19 mm respectively with 56 mm mean length of vertical extension. Conclusion HSPR is better depicted on thin-section CT images and multiplanar reformations which can be helpful for distinguishing confidently from abnormal findings such as lymph- adenopathy and cystic lesions.