儿童腹部囊性淋巴管瘤MRI与CT影像学表现及诊断分析

MRI and CT Imaging Findings and Diagnosis of Abdominal Cystic Lymphangioma in Children

目的探究儿童腹部囊性淋巴管瘤MRI与CT影像学表现并分析两种影像学的诊断价值。方法选取2012年8月至2017年8月于我院就诊并通过手术病理证实为腹部囊性淋巴管瘤的儿童19例,回顾性分析患儿术前MRI和CT影像学检查图像特征。结果经术后病理检查发现,19例患儿中有11例位于肠系膜,5例位于后腹膜,2例位于大网膜囊,1例位于两侧肾上腺。CT图像显示病灶内壁都很薄且病灶内部形态不规则,囊性薄壁肿块为单房或多房,大的病灶围绕血管、胃壁及肠腔。部分病灶部位之间可见分隔,呈水样密度,注入对比剂后,囊壁与间隔轻度强化,囊内不强化。MRI图像显示病灶部位出现较长T1及T2信号。结论 MRI与CT检查能清楚显示腹部囊性淋巴管瘤的主要位置、范围及内部特征,反应患者的具体病情,对患者术前诊断及手术均具有重要的意义,可将这两种影像学检查应用于儿童腹部囊性淋巴管瘤的诊断中,帮助医生诊断并制定出科学的治疗方案。

Objective To investigate the value of MRI and CT findings in the diagnosis of abdominal cystic lymphangioma in children.Methods A total of 19 children with abdominal cystic lymphangioma diagnosed in the hospital during the period from August 2012 to August 2017 were selected.Their MRI and CT image features before operation were retrospectively analyzed.Results Postoperative pathological examination showed that tumors in 11 of the 19 children were located in the mesentery,5 in the posterior peritoneum,2 in the larger omental sac and 1 in both adrenal glands.CT images showed that the inner walls of lesions were thin and the inner shape was irregular.The cystic thinwall masses were single-cavity or multi-cavity,with lesions surrounding the blood vessels,stomach wall and intestinal lumen.There was septation between some lesions and showed water-like density.After injection of contrast agents,the wall and the septum were slightly enhanced,and the capsule was not enhanced inside.MRI images showed longer T1 and T2 signals at the diseased site.Conclusion MRI and CT can clearly show the main position,range and internal characteristics of abdominal cystic lymphangioma,reflect the specific conditions of the patient,which is of great significance for preoperative diagnosis and surgery.The two imaging examinations can be used for the diagnosis of abdominal cystic lymphangioma in children and helps doctors diagnose and formulate scientific treatment plans.