纵隔成熟型囊性畸胎瘤的影像学表现

The Imaging Findings of Mediastinal Mature Cystic Teratoma

目的:探讨纵隔成熟型囊性畸胎瘤的CT和MRI特征。方法:回顾性分析18例经手术病理证实的纵隔成熟型囊性畸胎瘤患者的CT和MRI资料。结果:18例均位于前纵隔,6例偏左,10例偏右,2例居中。15例呈类圆形,3例呈分叶状。单房病变12例,多房病变6例。病灶大部分呈水样密度伴有局灶性脂肪成分(6例)和多发斑点状或蛋壳状钙化(3例)。T1WI和T2WI呈混杂信号,伴多灶性T1WI高信号区域。18例均为显壁囊肿,2例囊壁内有软组织结节,3例囊内见脂密度子囊。2位患者咳出毛发及皮脂样物质,CT示病灶局部浸润肺实质。CT增强扫描示囊壁和实性成分强化。结论:前纵隔单发水样密度的显壁囊肿,伴有脂密度子囊和/或不同形态钙化对本病有特异性诊断意义。

Objective: To explore the CT and MRI features of mediastinal mature cystic teratoma. Methods: CT and MRI images of18 patients with pathological confirmed mediastinal mature cystic teratoma were retrospectively analyzed. Results: All of the lesions were located in the anterior mediastinum, 6 cases protruded to the left side, 10 cases protruded to the right side, and 2 cases in the middle. 15 cases were round, 3 cases were lobulated. 12 cases were mono cystic lesion, 6 cases were multilocular lesion. Most part of the lesions were water sample density with small foci of fat(6 cases) and multiple punctate or egg-shell like calcification(3 cases). The mass showed heterogenous intensity on both T1 WI and T2 WI and also some areas with high signal intensity on T1 WI. All of the cases had the characteristics of "obvious-walled cysts", 2 cases had soft tissue nodules within the cystic walls, fatty density filial cyst in 3 cases.2 patients had expectoration of hair and sebaceous material and the masses focally infiltrated pulmonary parenchyma in the CT images.Contrast-enhanced CT showed mass with enhanced capsule and solid components. Conclusion: The imaging features of diagnostic significance of mediastinal mature cystic teratoma are water-density cysts of thick wall, accompany fatty density filial cyst, and/or different shape calcification in the isolated anterior mediastinum mass.