纵隔血管瘤11例影像学表现分析

Imaging Analysis of Mediastinum Hemangioma in 11 Cases

目的:探讨纵隔血管瘤计算机断层扫描(CT)及磁共振成像(MRI)影像学特征,提高其术前诊断准确性。方法:回顾性分析皖南医学院第一附属医院(弋矶山医院)2016年10月-2021年12月经手术病理证实并且具有影像资料的纵隔血管瘤患者11例。所有患者均行CT平扫及增强检查,其中1例行MRI平扫检查。评估病灶发生部位、形态/生长方式、边界、密度/信号、强化情况及其他影像学表现。结果:病灶发生在前、后纵隔单独受累分别为5、3例,前-中纵隔共同受累1例,前-中-后纵隔共同受累2例。不规则肿物6例,呈弥漫性蔓延式生长;分叶状肿物2例,与纵隔血管宽基底相贴;类圆形肿物3例,呈轻度蔓延式生长。9例边界不清楚,2例边界清楚。混杂密度灶5例,均见裂隙样脂肪密度影与弯条状/结节状软组织密度影相间存在,且均见静脉石;均匀软组织等密度灶4例,其中1例见裂隙状脂肪信号;软组织等密度灶伴水样低密度影2例。7例呈渐进式轻度强化或无强化,4例呈渐进式显著强化;3例见斑片/结节状强化影,2例见粗大引流静脉,1例见腔静脉造影剂逆行灌注,7例见血管影。有2例可疑肝脏血管瘤,1例可疑脾脏多发脉管瘤。结论:纵隔血管瘤具有一些特征性影像学表现,CT和MRI有助于其术前准确诊断。

Objective:To explore the imaging features of mediastinum hemangioma (MH) by computed tomography (CT) and magnetic resonance imaging (MRI) in order to improve its accuracy of reoperative diagnosis.Method:A total of 11 cases with MH confirmed by surgery and pathology and with imaging data in the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital) from October 2016 to December 2021 were retrospectively analyzed.All patients underwent CT plain scan and enhanced scan,and 1 patient underwent MRI plain scan.The location,shape/growth pattern,boundary,density/signal,enhancement information and other imaging manifestations of the lesions were evaluated.Result:The lesions occurred in the anterior and posterior mediastinum in 5 cases and 3 cases,respectively.The anterior and middle mediastinum were jointly involved in 1 case,the anterior,middle and posterior mediastinum jointly in 2 cases.There were 6 cases of irregular tumor,which showed diffuse growth,lobulated tumor in 2 cases,closed to the broad base of mediastinal vessels,and there were 3 cases of round like tumor with mild spreading growth.There were 9 cases had unclear boundary and 2 cases had clear boundary.In 5 cases of mixed density foci,fissure like fat density shadow and curved strip/nodular soft tissue density shadow were seen alternately,and venous stones were seen in all cases.Homogeneous soft tissue isodensity foci were found in 4 cases,of which 1 case showed fissured fat signal,soft tissue isodensity foci with watery low density shadow in 2 cases.There were 7 cases showed gradual mild enhancement or no enhancement,and 4 cases showed gradual obvious enhancement.Patch/nodular enhanced shadows were seen in 3 cases,large draining veins in 2 cases,retrograde perfusion of contrast medium in vena cava in 1 case,and vascular shadows in 7 cases.There were 2 cases of suspected hepatic hemangioma and 1 case of suspected splenic multiple angioma.Conclusion:Mediastinal hemangioma has some characteristic imaging findings.CT and MR are helpful for its accurate preoperative diagnosis.