骶前尾肠囊肿的磁共振影像表现

MRI findings of sacrococcygeal cyst

目的分析骶前尾肠囊肿的磁共振(MRI)影像表现特点,以提高对该病的认识。方法收集2018年1月至2021年5月柳州市中医医院经手术病理证实的5例骶前尾肠囊肿患者的临床及磁共振影像资料,所有患者术前均接受磁共振平扫及增强扫描检查,分析其MRI表现。结果5例骶前尾肠囊肿中1例合并感染,1例合并感染并肛瘘形成,3例为单纯囊肿。5例尾肠囊肿均显示为囊性病灶,其中4例为多房囊性或囊内有分隔,1例为单囊。单纯尾肠囊肿囊液T1WI呈等或低信号,T2WI-FS呈明显高信号,DWI上无弥散受限,囊液无强化;囊壁光滑、均匀,T1WI及T2WI-FS上均呈等或低信号,增强扫描囊壁及分隔轻度强化。合并感染的病例局部囊壁增厚,增强扫描明显强化;瘘管表现为管状病灶,管腔在T1WI上低信号,T2WI-FS上高信号,管腔内黏液在DWI上弥散受限,增强扫描管壁强化。结论术前MRI检查能明确尾肠囊肿的位置、形态及大小,显示病灶与周围组织的关系,有助于与其他骶前占位性病变相鉴别,分辨病变的良恶性,以指导临床开展正确的手术治疗。

Objective To analyze the MRI features of sacrococcygeal cyst in order to improve the understanding of the disease.Methods The clinical and MRI data of 5 patients with sacrococcygeal cysts confirmed by surgery and pathology in Liuzhou Hospital of Traditional Chinese Medicine from January 2018 to May 2021 were collected.All patients underwent plain and enhanced MRI before operation,and their MRI findings were analyzed.Results Among the 5 cases of sacrococcygeal cysts,1 case was complicated with infection,1 was with infection and anal fistula,and 3 cases were simple cyst.The 5 cases all showed cystic lesions,among which 4 were multilocular cystic or separated in the capsule and 1 was single capsule.The cystic fluid of simple caudal cyst showed equal or low signal on T1WI,obvious high signal on T2WI-FS,and no diffusion limitation or enhancement of cystic fluid on DWI.The capsule wall was smooth and uniform.There were equal or low signals on T1WI and T2WI-FS.In the case of the patients with infection,the capsule wall was thickened and significantly enhanced on enhanced scanning.The fistula showed tubular lesions,low signal on T1WI and high signal on T2WI-FS.The diffusion of mucus in the lumen was limited on DWI,and the tube wall was enhanced on enhanced scanning.Conclusion Preoperative MRI examination can clarify the location,shape,and size of caudal cyst,show the relationship between the focus and surrounding tissues,help to distinguish it from other presacral space occupying lesions,and distinguish the benign and malignant lesions,so as to guide clinical correct surgical treatment.