成人肺内支气管源性囊肿的CT表现

CT findings of intrapulmonary bronchogenic cyst in adult

目的分析成人肺内支气管源性囊肿的CT表现特点。方法回顾性分析2014年2月至2019年12月于天津市胸科医院经组织病理学检查结果证实为肺内支气管源性囊肿的46例患者的影像学资料, 其中男性25例、女性21例, 年龄23~74 (48.3±8.1)岁。所有患者均行CT平扫检查, 其中31例患者同时行增强CT检查。根据CT表现特点分析患者肺内病变的部位、数量、周围的肺组织改变及合并症等。结果 46例患者中, 42例为单发、4例为多发(3例位于同侧肺的不同肺叶, 1例位于双肺)。所有患者中CT表现为含液囊肿的有16例、含气囊肿10例、蜂窝及肿块样囊肿20例。囊肿周围肺改变以小索条、肺透过度增高、肺不张及实变为主, 分别有24例、18例、25例。术后组织病理学检查结果证实支气管源性囊肿病灶无合并症20个、合并曲霉菌感染12个、其他感染10个、结核6个、肿瘤(类癌)1个。结论 CT图像所示的成人肺内支气管源性囊肿的含液、含气囊肿具有圆形或类圆形形态, 其内为单纯液体或气体, 具有一定的鉴别诊断价值。当形成蜂窝及肿块样囊肿时, 需要与肺结核、肺癌等相鉴别。

Objective To analyze the CT features of intrapulmonary bronchiogenic cyst in adults.Methods Imaging data of 46 patients(25 males,21 females,23-74(48.3±8.1)years old)with intrapulmonary bronchiogenic cyst confirmed by histopathological examination results in Tianjin Chest Hospital from February 2014 to December 2019 were analyzed retrospectively.All patients underwent CT examination,31 of whom underwent contrast-enhanced CT examination.According to the CT features,the location and number of intrapulmonary lesions,the changes in surrounding lung tissue,and the complications were analyzed.Results Among the 46 patients,42 cases were single and 4 cases were multiple(3 cases were located in different lobes of the ipsilateral lung,and 1 cases was located in both lungs).Among all patients,16 cases with fluid-containing cysts,10 cases with balloon-like cysts,and 20 cases had honeycomb and mass-like cysts.The main lung changes around the cysts were small cord(24 cases),excessive increase of pulmonary permeability(18 cases),and atelectasis and consolidation(25 cases).Postoperative histopathological examination results confirmed that there were 20 bronchogenic cyst lesions without complications,12 lesions with aspergillus infection,10 lesions with other infections,6 lesions with tuberculosis,and 1 lesion with tumor(carcinoid).Conclusions Fluid-containing and gas-containing cysts shown in CT images of the adults intrapulmonary bronchiogenic cyst had round or quasi-circular shapes,which were simple liquid or gas and had a certain value of differential diagnosis.When honeycomb and mass-like cysts form,they need to be distinguished from pulmonary tuberculosis and lung cancer.