纵隔低密度肿块病变的CT诊断

CT diagnosis and differential diagnosis of low attenuation mediastinal masses

目的 :提高纵隔低密度肿块病变的CT诊断水平。方法 :回顾性分析 52例经临床、手术及病理确诊的纵隔低密度肿块病例资料。结果 :52例中皮样囊肿 4例 ,畸胎瘤 6例 ,胸腺囊肿 3例 ,支气管囊肿 5例 ,心包囊肿 4例 ,脂肪瘤 1例 ,胸内甲状腺肿囊变 4例 ,胸腺瘤囊变 6例 ,淋巴结肿囊变 7例 (淋巴瘤 2例 ,淋巴结结核 5例 ) ,神经源性肿瘤囊变 4例(神经节细胞瘤 1例 ,神经鞘瘤 2例 ,恶性神经纤维瘤 1例 ) ,纵隔血肿 2例 ,纵隔脓肿 6例。CT诊断正确率 92 .3 % (48/52 )。结论 :纵隔低密度病变种类较多。CT检查可清楚显示病变的部位与特点 ,结合临床表现一般能作出准确的术前诊断。

Objective:To improve the accuracy in diagnosing low attenuation mediastinal masses on CT scans. Methods: CT images of 52 cases with low attenuation mediastinal masses,confirmed by clinical data,surgery and pathology,were analyzed.Results:52 low attenuation mediastinal masses included dermoid cyst (n=4),teratoma(n=6),thymic cyst(n=3),bronchial cyst(n=5 ),pericardial cyst(n=4),lipoma(n=1),intrathoracic cystic goiter(n=4),thymic tumor with cystoid degeneration(n=6),enlarged lymph nodes with cystoid degeneration (including 2 of lymphoma and 5 of tuberculous lymph nodes),neurogenous tumor with cystoid degeneration(1 of ganglionic neuroma,2 of schwannomas,1 of malignant neurofibroma),mediastinal hematoma (n=2),mediastinal abscess(n=6).48 cases in this study were correctly diagnosed by CT scans before surgery (92.3%).Conclusion:There are various kinds of low attenuation mediastinal masses,CT scan can clearly display the location and characteristics of them.With combination of CT and clinical data,correct diognosis of low attenuation mediastinal masses can be established before operation.