小儿支气管肺囊肿CT影像的病理学基础

Histopathology underlying computed tomography in bronchogenic cyst

目的探讨小儿支气管肺囊肿CT影像学的病理学基础,以期提高临床诊断水平。方法回顾性分析60例支气管肺囊肿患儿的临床资料,男36例,女24例;平均年龄12岁(28d～14岁3个月),其中<6个月9例。增强CT提示临床表现及组织病理发现的相互关联性。结果CT影像显示囊内为单纯气体密度影27例,气液混合囊肿27例,软组织回声6例。囊肿大小与含气程度和临床表现无明显关联。周围组织的CT表现,毛玻璃状改变和厚壁与慢性肺部炎症以及肺部病理的改变明显相关(P=0.008)。结论有明显CT改变的支气管肺囊肿与临床表现及组织病理改变有关。

Objectives To investigate the correlation between histopathology of bronchogenic cyst （BC） and computed tomography （CT） image. Methods Clinical data of 60 patients with BC were retrospectively reviewed. There were 24 females and 36 males averaged 12 years o1,t （28 d to 14.25 y） . Contrast-enhanced CT findings were characterized and correlated with clinical presentation and h^stopathologic findings （using Fisher＇s exact tests） . Resulls The majority of intrapulmonary BCs were subpleural in location （55%）, in the lower lobes （60%）, symptomatic （80%） . Three CT patterns were identified： cyst with content of fluid attenuation （27 patients）, cyst with air and fluid content （27 patients）, cyst with content of soft tissue attenuation （6 patients） . If using the CT criteria of cysts, preoperative diagnosis of intrapulmonary BC can be made correctly only in 20%. Cysts with air component were significantly larger than those without air component （P = 0.0452）, but cyst size and air component were not correlated with clinical presentation. Surrounding infiltration or thick wall on CT were significantly correlated with the presence of any clinical symptoms （P = 0.014） or fever （P = 0,042）. CT findings of surrounding consolidation, ground glass opacity or thick wall were significantly correlated with chronic inflammation or pneumonic change on histopathology （P = 0.008）. Conclusions There is a wide spectrum of BCs on CT findings that are correlated with clinical presentations and histopathologic findings.