纵隔囊性病变的CT诊断

CT diagnosis of cystic lesions arising in the mediastinum

目的探讨纵隔囊性病变的CT诊断和鉴别诊断。方法回顾性分析38例经临床病理证实的纵隔囊性病变患者的CT资料、病理及临床表现,术前均行CT平扫,28例同时行增强扫描。结果支气管囊肿10例,7例位于中纵隔,3例位于后纵隔;心包囊肿8例,6例位于前纵隔,2例位于中纵隔;胸腺囊肿3例,均位于前纵隔;食管重复囊肿1例,位于后纵隔;胸内甲状腺囊肿1例,位于中纵隔;囊性畸胎瘤8例,6例位于前纵隔,2例位于后纵隔;淋巴管瘤1例,跨前、中纵隔;神经鞘瘤囊性变5例,均位于后纵隔;纵隔转移性淋巴结囊性变1例,位于中纵隔。结论 CT检查可清楚显示纵隔囊性病变的位置、形态及其与邻近结构的关系,结合临床表现,常可于术前作出定性诊断。

Objective To study CT diagnosis and differential diagnosis of cystic lesions arising in the mediastinum.Methods Thirty-eight patients with surgically and pathologically proved mediastinal cystic lesions（MCL） underwent conventional CT scans of the chest before the operation,of whom,28 patients underwent additional contrast-enhanced CT scans.CT findings,pathologic and clinic manifestations in all patients were retrospectively analyzed.Results Among 38 patients with MCL,bronchial cysts were fund in 10 cases,which comprised 7 in middle mediastinum and 3 in posterior mediastinum;pericardial cysts in 8 cases,which comprised 6 in anterior mediastinum and 2 in middle mediastinum;thymic cysts in 3 cases,which were located in anterior mediastinum;esophageal duplication cyst in 1 case,which was located in posterior mediastinum;intrathoracic thyroid cyst in 1 case,which was located in middle mediastinum;cystic teratoma in 8 cases,which comprised 6 in anterior mediastinum and 2 in posterior mediastinum;lymphangioma in 1 case,which invaded into anterior-middle mediastinum;cystic neurinoma in 5 cases,which were located in posterior mediastinum;cystic degeneration of metastatic lymph node in 1 case,which was located in middle mediastinum.Conclusion CT scan could clearly show the location,shape of MCL and its relationship with neighbor structures,and thus CT features combined with clinical history can make a correct diagnosis before surgery.