纵隔解剖“三分区”在占位病变诊断中的应用

Application of three compartments of mediastinal anatomy in the diagnosis of space-occupying lesions

目的 探讨纵隔解剖“三分区”在占位性病变定位定性诊断中的应用价值。方法 回顾性观察 78例经手术病理证实的纵隔占位患者的CT图像 ,按照纵隔“三分区” ,统计不同性质占位病变在纵隔各区内分布的情况。结果 病变分布的情况如下 :前上纵隔病变依次为淋巴结肿大、胸腺肿瘤、畸胎类肿瘤、胸内甲状腺肿和其他少见肿瘤 ;前下纵隔病变依次为心脏心包肿瘤、畸胎类肿瘤、脂肪肿瘤及其他少见病变 ;后纵隔病变依次为淋巴结肿大、神经源性肿瘤、食管肿瘤、动脉瘤 (包括夹层动脉瘤 )、膈疝及其他少见病。结论 纵隔“三分区”不仅简便易记 ,可用于各种影像学手段 ,而且根据器官组织在不同纵隔内分布的规律 ,可对病变作出更精确的定位定性诊断。

Objective To evaluate three compartments of mediastinal anatomy in the diagnosis of space occupying lesions. Methods CT images of 78 mediastinal lesions confirmed by surgery or/and pathology were retrospectively studied. Results According to the occurrence ratio of occupying lesions, anterio superior mediastinal lesions were lymphadenovarix, thymoma, teratoblastoma, and intrathyroma, etc. In anterio inferior mediastinum, heart tumors, teratoblastoma, fatty tumor were found successively. Posterior mediastinal lesions were lymphadenovarix, neurogenic tumors, esophageal tumors, tracheo broncheal tumors, aneurysms, diaphrageal herniation and so on. Conclusion The results suggested that the mediastinal three compartments protocol was more terse and practical than others in the diagnosis of space occupying lesions before operation.