淋巴管瘤的影像学表现

Imaging Findings of Lymphangioma

目的:探讨淋巴管瘤的影像学表现及其与病理的相关性。方法:经手术病理证实的淋巴管瘤26例,男15例,女11例,年龄1个月～68岁,平均19.4岁。7例行CT检查纳入研究,其中6例有平扫加增强扫描;1例行MRI检查;24例行超声检查。结果:CT上病灶均为囊性病变,密度均匀,边界较清楚,壁薄。2例病灶呈单房,5例病灶内可见分隔并形成多房,增强扫描囊壁及部分分隔强化,囊内未见强化。MRI上病变在T1WI上为低信号,T2WI上呈高信号,病变信号不均匀,边界欠清楚,其内见分隔。超声声像图上病灶均为囊实性低回声或无回声肿块影,其中10例病变回声不均质,14例探及条形分隔反射,其中3例分隔为蜂窝状、网状,3例边界不清;彩色多普勒血流成像探及囊内及分隔内血流7例。手术病理显示病变全部为囊性,可看到扩张的淋巴管,有些病灶内可见血管,并见一些纤维组织及脂肪组织成分。结论:淋巴管瘤有较为典型的影像学表现:囊性,薄壁肿块,密度较均匀,边界较清楚;病理与影像一致性好。

Purpose： To investigate the imaging findings of lymphangioma and its correlation with pathology. Methods： Twenty - six patients with lymphangioma confirmed by surgery and pathology were enrolled. There were 15 male and 11 female with an average age of 19.4±20.1 y （ranged from 1 month to 68 y）. Seven patients were performed CT, including 6 patients with noncontrast and contrast CT. One patient was performed MR imaging. Twenty - four patients were performed Ultrasound （US） examina- tion. Results： On CT imaging, lymphangioma showed cystic, uniform density and thin wall mass with well - defined margin. Two lesions were monolocular, and five were multilocular with septum. The wall and some septum of the lesions were enhanced, while the inner parts of the lesions were not enhanced on enhanced CT images. On MR imaging, the lesion showed hypointense on T1 weighted and hyperintense on T2 weighted images with ill - defined margin. The lymphangiomas on US showed cystic and hypoechoic or anechoic masses. Ten lesions had homogenous echo, fourteen lesions had septum and three lesions were with ill - defined margin. Seven lesions showed blood flow on color Doppler flow imaging. Lymphan- giomas showed cystic lesions with dilated lymph vessels confirmed by surgery and pathology. Angiogen- esis can be seen in some lesions associated with a little of fibrosis and fat. Conclusion： Lymphangioma are usually cystic, non - enhanced with thin wall, homogenous density and well - defined margin masses on imaging modalities. The imaging features of the lesions reflected their pathology.