摘要
目的探究儿童腹部囊性淋巴管 瘤MRI与CT影像学表现并分析两种影像学 的诊断价值。方法 选取2012年8月至2017 年8月于我院就诊并通过手术病理证实为 腹部囊性淋巴管瘤的儿童19例,回顾性 分析患儿术前MRI和CT影像学检查图像特 征。结果 经术后病理检查发现,19例患 儿中有11例位于肠系膜,5例位于后腹 膜,2例位于大网膜囊,1例位于两侧肾上 腺。CT图像显示病灶内壁都很薄且病灶内 部形态不规则,囊性薄壁肿块为单房或多 房,大的病灶围绕血管、胃壁及肠腔。部 分病灶部位之间可见分隔,呈水样密度, 注入对比剂后,囊壁与间隔轻度强化,囊 内不强化。MRI图像显示病灶部位出现较 长T1及T2信号。结论 MRI与CT检查能清楚 显示腹部囊性淋巴管瘤的主要位置、范围 及内部特征,反应患者的具体病情,对患 者术前诊断及手术均具有重要的意义,可 将这两种影像学检查应用于儿童腹部囊性 淋巴管瘤的诊断中,帮助医生诊断并制定 出科学的治疗方案。
Objective To investigate the value of MRI and CT findings in the diagnosis of abdominal cystic lymphangioma in children. Methods A total of 19 children with abdominal cystic lymphangioma diagnosed in the hospital during the period from August 2012 to August 2017 were selected. Their MRI and CT image features before operation were retrospectively analyzed. Results Postoperative pathological examination showed that tumors in 11 of the 19 children were located in the mesentery, 5 in the posterior peritoneum, 2 in the larger omental sac and 1 in both adrenal glands. CT images showed that the inner walls of lesions were thin and the inner shape was irregular. The cystic thinwall masses were single-cavity or multi-cavity, with lesions surrounding the blood vessels, stomach wall and intestinal lumen. There was septation between some lesions and showed water-like density. After injection of contrast agents, the wall and the septum were slightly enhanced, and the capsule was not enhanced inside. MRI images showed longer T1 and T2 signals at the diseased site. Conclusion MRI and CT can clearly show the main position, range and internal characteristics of abdominal cystic lymphangioma, reflect the specific conditions of the patient, which is of great significance for preoperative diagnosis and surgery. The two imaging examinations can be used for the diagnosis of abdominal cystic lymphangioma in children and helps doctors diagnose and formulate scientific treatment plans.
【关键词】腹部囊性淋巴管瘤;儿童; CT;MRI
【中图分类号】R733.4;R445.2;R445.3
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.10.043
前言
囊性淋巴管瘤又称囊性水瘤,是由原始淋巴管增生形成的肿物, 属于中皮层淋巴管源性良性病变,是一种先天性发育畸形,是肿瘤和 畸形之间交界性病变[1]。囊性淋巴管瘤虽然属于良性病变,但其具有 浸润的特点,可向周围组织或器官浸润生长,导致患者出现并发症, 严重时会危及患者生命,故早期的诊断和积极治疗对患者的恢复及 预后具有重要的意义[2]。淋巴管瘤多发于儿童,90%发病见于2岁前儿 童,成人少见,常见于面部、颈部及四肢,发生于腹部较为少见[3-4]。 因此,本研究采用回顾性分析方式,分析儿童腹部囊性淋巴管瘤MRI与 CT影像学表现及诊断价值,旨在探索两种影像学检查在诊断儿童腹部 囊性淋巴管瘤中的价值。
中国CT和MRI杂志
第16卷, 第 10 期
2018年10月
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