MRI对直肠海绵状血管瘤的临床应用价值

The clinical value of MRI in rectal cavernous hemangioma

目的:分析直肠海绵状血管瘤的MRI表现,探讨MRI对直肠海绵状血管瘤的临床应用价值。方法:搜集经手术及病理证实的直肠海绵状血管瘤8例,均行MRI平扫及增强检查,回顾性分析其MRI表现。结果:8例(100%)均表现为直肠壁明显增厚,以黏膜下层增厚为著,T2WI及FS-T2WI呈显著高信号。7例(87.5%)直肠系膜内可见大量迂曲条索状异常信号影,T2WI呈等信号,FS-T2WI呈高信号,直肠系膜呈明显不均质改变。1例(12.5%)病灶内可见多发结节状低信号无强化静脉石。8例(100%)病灶呈进行性强化。1例(12.5%)病灶局限于直肠黏膜下层,累及乙状结肠;7例(87.5%)病灶累及直肠壁全层,其中3例累及肛管,4例同时累及乙状结肠与肛管。6例(75.0%)累及直肠系膜,1例(12.5%)病灶累及直肠系膜及周围结构。结论:直肠海绵状血管瘤的MRI表现具有特异性,MRI能对直肠海绵状血管瘤进行定性诊断,并能全面评价其累及范围,对临床诊断、合理治疗方案的制订具有重要价值。

Objective:To analyze image findings and diagnostic value of MRI in cavernous hemangioma of the rectum.Methods:The non-enhanced and enhanced MRI findings of 8 cases of cavernous rectal hemangioma confirmed by pathology were retrospectively analyzed.Results:All the patients(100%)showed apparent thickening of the rectal wall,especially submucosa,with marked hyperintensity on T2WI and FS-T2WI.Seven cases(87.5%)had markedly heterogeneous perirectal fat,containing serpiginous structures with isointensity on T2WI and hyperintensity on FS-T 2WI.Multiple phleboliths with low signal and no enhancement were observed in 1 patient(12.5%).Eight cases(100%)presented progressive enhancement.The lesion was confined to the rectal submucosa and involved the sigmoid colon in 1 case(12.5%).The lesion involved the whole layer of the rectal wall in 7 cases(87.5%)including 3 cases involved the anal canal and 4 cases involved the sigmoid colon and the anal canal simultaneously.The lesions involved the mesorectum in 6 cases(75.0%),mesorectum and its surrounding structures in 1 case(12.5%).Conclusion:The cavernous rectal hemangioma has specific MRI manifestations.MRI can do etiologic diagnosis of rectal cavernous hemangioma and overall assess its extent of involvement,which has significant clinical value for clinical diagnosis and rational treatment plan.