纵隔血管瘤多层螺旋CT表现

Multi-slice spiral CT features of mediastinal hemangiomas

目的探讨纵隔血管瘤的多层螺旋CT表现。方法回顾性分析13例纵隔血管瘤的CT资料,观察病变部位、形状、大小、边缘、密度和强化模式、肿块-心脏大血管界面(MCI)和肿块-肺界面(MPI)及其他征象。结果 13例血管瘤均为单发肿块,边缘模糊,位于前中纵隔6例、前中后纵隔4例、右后纵隔3例。10例呈弥漫性蔓状生长,形态不规则,MCI模糊并轻度占位效应9例、明显占位效应1例;2例呈轻度蔓状生长,哑铃状,并延伸入椎管压迫脊髓;1例呈膨胀性生长,椭圆形。MPI清晰12例,模糊1例。8例为混合密度并周边条索状软组织,2例为均匀密度,3例以脂肪密度为主并结节或条索状软组织,其中5例见静脉石;13例均呈结节状或条索状强化并延迟强化,其中12例见引流静脉、7例见供血动脉;4例合并脾脏血管瘤。结论纵隔血管瘤CT表现具有一定特征,增强CT扫描有助于准确诊断和术前评估。

Objective To explore the imaging findings of mediastinal hemangiomas (MH) on multi-slice spiral CT.Methods CT findings of 13 patients with MH were analyzed retrospectively.The location,shape,size,margin,density and enhancement pattern,mass-cardiovascular interface (MCI),mass-pulmonary interface (MPI) and other appearances of MH were observed.Results Single mass with obscure margin was found in all 13 patients,located at anterior-middle mediastinum in 6 cases,at anterior-middle-posterior in 4 cases,while at posterior mediastinum in 3 cases.Diffuse pampiniform growth mass was found in 10 cases,with irregular-shape and obscure MCI,while mild and significant mass effect were observed in 9 cases mass and 1 case,respectively.Mild pampiniform growth and dumbbell-shape mass were observed in 2 cases,extended into spinal canal and compressed the spinal cord,and 1 mass showed expansive growth and oval-shape.MPI were clear in 12 cases and obscure in 1 case.Eight masses showed mixed density with stripe-like soft tissue in peripheral area,2 masses showed homogenous density,3 masses showed predominant fatty tissue with nodular or stripe-like soft tissue,among which the phleboliths were seen in 5 cases.All 13 masses showed heterogeneously nodular or stripe-like enhancement with delayed-enhancement,while significant draining veins were simultaneously seen in 12 cases,blood supply arteries in 7 cases and splenic hemangioma in 4 cases.Conclusion CT findings of MH are relatively specific.Enhanced CT is valuable for preoperative evaluation and accurate diagnosis of MH.