椎管内淋巴管瘤的影像学表现(附3例报告并文献复习)

目的探讨椎管内淋巴管瘤的影像特征。方法报道3例椎管内淋管瘤并参考相关文献分析其影像特点。结果2例病变位于骶管,1例位于腰段椎管。MR均表现为内有分隔的囊性病变。结论椎管内硬膜外有分隔的囊性病变可以提示淋巴管瘤的诊断。CT对椎管内淋巴管瘤的诊断帮助不大,MR对椎管内淋巴管瘤的诊断价值较大。     

胎儿颈部囊性淋巴管瘤的影像学表现

目的:探讨胎儿颈部囊性淋巴管瘤的超声和MRI表现,着重评价MRI诊断胎儿颈部囊性淋巴管瘤的价值及临床意义。方法:回顾性分析10例有完整资料的胎儿颈部囊性淋巴管瘤的超声和MRI表现,并与随访和引产后尸检结果对照。结果:囊性淋巴管瘤的影像学特征为头颈部两侧或背侧的囊性包块,呈单囊或多囊表现,回声或信号可均匀或不均匀,病变范围可延伸至枕部或肩背部及纵隔。本组2例B超诊断为脑脊膜膨出,后行MRI检查,MRI诊断及引产后尸检证实为颈部淋巴管瘤。结论:超声和MRI均能清楚显示胎儿颈部淋巴管瘤的形态轮廓和病变范围,但MRI可以多平面成像,软组织分辨力高,可作为超声检查的重要补充,有利于颈部囊性病变的鉴别诊断。     

Cystic masses of the spleen: radiologic-pathologic correlation.

Many focal splenic lesions may appear to be cystic at cross-sectional imaging. In this article, the following types of cystic splenic masses are discussed: congenital (true cyst), inflammatory (abscesses, hydatid cyst), vascular (infarction, peliosis), posttraumatic (hematoma, false cyst), and neoplastic (hemangioma, lymphangioma, lymphoma, metastasis). The key findings at ultrasound, computed tomography, and magnetic resonance imaging can be correlated with underlying gross and microscopic pathologic findings. Although tissue sampling is still required in many cases to yield a definitive diagnosis, recognition and understanding of the spectrum of imaging and pathologic features of these lesions often help narrow the differential diagnosis.     

CT 诊断脾脏淋巴管瘤的应用价值

目的：通过分析脾脏淋巴管瘤的C T表现特征,探讨其影像诊断价值。方法搜集15例经病理证实的脾脏淋巴管瘤的CT资料,对其CT表现进行回顾性分析。结果脾脏囊状淋巴管瘤6例,海绵状淋巴管瘤9例。单发病灶7例,多发病灶8例。3例边缘清晰,12例边缘模糊。除单发单房病灶及多发单房病灶中1个病灶无分叶状轮廓改变外,余病灶轮廓均显示形态不规则,呈分叶状改变。病灶内呈稍高密度网格状分隔（除单发单房及多发单房中一个病灶外）及低密度之液性区（除1例出现分层征象,下层为稍高密度影）。增强后动脉期、门静脉期囊壁及分隔13例轻中度强化,2例延迟期轻度强化。结论脾脏淋巴管瘤的CT表现具有一定特征性,CT是临床正确诊断的重要影像学检查方法。     

小儿颈部囊性病变的高频超声与CT表现

目的:探讨小儿颈部囊性病变的高频超声及CT表现.方法:48例经手术病理证实的颈部囊性痛变患者,均行超声和CT检查,回顾性分析其超声和CT特点.结果:48例中甲状舌管囊肿21例(43.8%),颈淋巴管瘤18例(37.5%),鳃裂囊肿9例(18.8%).颈部囊性病变各有其好发部位.甲状舌管囊肿多见于颈中线附近、舌骨上下;淋巴管瘤多见于颈侧部、锁骨上,范围较广;腮裂囊肿多见于中上侧颈部.甲状舌管囊肿及鳃裂囊肿呈单房性,淋巴管瘤多为多房性.结论:高频超声和CT检查可清晰显示病变的大小、形态和延伸范围,对颈部囊性病变具有重要的诊断和鉴别诊断价值.     

A case of mesenteric cystic lymphangioma: fat saturation and chemical shift MR imaging

Mesenteric cystic lymphangioma is an uncommon lesion that may be difficult to diagnose radiologically. In our case, a septate cystic mass showed fluid attenuation on a computed tomography scan. We were able to define the fat content within the cystic tumor by magnetic resonance (MR) imaging. The presence of fat within an intra-abdominal cystic mass is suggestive of a dermoid cyst, cystic lymphangioma, or lymphocele. The pathologic diagnosis revealed a cystic lymphangioma, which originated from the mesentery. Although the MR imaging features of dermoid cysts and lymphangiomas are well known, the demonstration of fat content by chemical shift and fat saturation MRI has not yet been reported for a cystic lymphangioma.     

脾海绵状淋巴管瘤的CT诊断与鉴别诊断(附8例分析)

目的：通过分析脾脏海绵状淋巴管瘤的影像学表现特征,探讨其影像诊断和鉴别诊断。方法：回顾性分析8例经病理证实的脾脏海绵状淋巴管瘤的CT表现,并与其他脾脏囊性病变进行鉴别。结果：8例海绵性淋巴管瘤均为近脾门处单发囊性病灶,8例中2例病灶边界清晰,6例病灶边界模糊。所有病灶形态不规则,呈分叶状改变。囊内有分隔,壁略薄（厚度约3～5mm）,囊壁及分隔略呈稍高密度,灶内可见低密度液性区。增强后动脉期、门静脉期囊壁及分隔中度强化,延迟期仍持续强化。8例患者中5例无自觉症状,经体检中发现。仅有3例出现与脾肿大相关的临床症状（左上腹胀满或轻微胀痛）。结论：脾海绵状淋巴管瘤的CT表现具有一定特征性,但需与脾脏其他囊性病变相鉴别。     

纵隔囊性病变的CT与MRI诊断

目的：探讨纵隔囊性病变的CT、MRI诊断及鉴别诊断。方法：回顾性总结30例经手术、病理确诊的纵隔囊性病变的CT及MRI表现，包括胸腺囊肿7例，囊性畸胎瘤8例，气管、支气管囊肿9例，食管囊肿4例，囊性淋巴管瘤2例。结果：不同纵隔囊性病变均有其较特定的发病部位。7例胸腺囊肿中6例位于前上纵隔的胸腺区，1例位于前纵隔中下部；8例囊性畸胎瘤主要位于前纵隔中部、大血管起始处；9例气管、支气管囊肿位于中上纵隔，气管、支气管右旁区；4例食管囊肿，其中3例位于后纵隔，1例位于中纵隔；2例囊性淋巴管瘤，其中1例为颈纵隔型，1例为颈一腋纵隔型。结论：纵隔囊性病变虽无明显特征性影像学表现，仔细观察CT与MRI征象特点，结合发病部位，对提高本病的诊断具有重要意义。     

多层螺旋CT在儿童颈部囊状淋巴管瘤的应用

目的:探讨MSCT对儿童颈部囊状淋巴管瘤的诊断价值.方法:回顾性分析15例经病理证实的儿童颈部囊状淋巴管瘤MSCT表现并与手术病理所见对照.结果:儿童颈部囊状淋巴管瘤MSCT的特点:①多囊性;②可出现"液-液平面"征象;③沿疏松结缔组织生长;④增强扫描囊壁不强化或轻度强化,囊内容物不强化;⑤肿瘤包绕血管、神经及脂肪;⑥MSCT可以水平横断面、冠状面、矢状面结合显示病灶.结论:MSCT检查对儿童颈部囊状淋巴管瘤的诊断具有重要价值,有利于手术方案的制订,在评价肿瘤侵犯方面优于超声和普通CT.     

儿童腹部脏器外囊性病变的的CT诊断

目的:探讨CT对儿童腹部脏器外囊性病变的诊断价值。方法:回顾性分析35例经手术病理证实的儿童腹部脏器外囊性病变的CT表现。结果:淋巴管瘤11例,其中肠系膜淋巴管瘤7例,腹膜后淋巴管瘤4例,肿块形态不规则,囊壁菲薄,张力低,边缘清楚,其中8例可见线条状分隔,8例行增强扫描均未见强化。肠系膜囊肿8例,均为先天性肠系膜囊肿,形态较规则,边缘清晰锐利,囊壁薄而均匀,6例为单房,2例为多房,2例囊壁呈线状强化,6例囊壁无强化。大网膜囊肿4例,长径均大于6cm,病灶位于腹腔前方,紧贴前腹壁,形态不规则。肠重复畸形6例,均与肠管关系密切,4例呈管状,2例呈类圆形,4例囊壁可见强化。囊性畸胎瘤4例,3例位于腹膜后,1例位于骶尾部,2例囊壁可见线条状钙化。腹部脓肿2例,呈不规则液性密度区,囊壁较厚且厚薄不均,增强时明显强化。结论:CT对腹部脏器外囊性病变的形态特征、大小范围及与周围组织结构的关系显示清晰,能对大多数病变作出准确诊断。     

淋巴管瘤的影像学诊断与病理相关性分析

目的探讨淋巴管瘤的影像学表现与病理分型之间的关系,评价影像学诊断的价值。资料与方法搜集经手术病理证实的28例淋巴管瘤,其中行CT检查22例,MRI检查8例,3例经CT增强扫描,2例行MRI增强。回顾性分析其影像学表现。结果囊性淋巴管瘤19例,表现为单房或多房囊性薄壁肿块,密度均匀;海绵状淋巴管瘤5例,表现为蜂窝状结构,边缘不规则;血管淋巴管瘤3例．可有不均匀强化及“液-液”平面表现。单纯淋巴管瘤1例。结论影像学检查对淋巴管瘤的诊断具有重要价值,并能为临床治疗提供指导。     

Cystic lymphangiomas of the abdomen. CT and US findings

Cystic lymphangiomas of the abdomen are an uncommon kind of hamartoma. Their diagnosis is often difficult and calls for an accurate differential diagnosis of this disease and such lesions as cystic pancreatic neoplasms, pseudocysts, hematomas, abscesses and urinomas. Eight cases of abdominal lymphangioma are reported, in patients ranging 35 to 68 years; all lesions were uni/multilocular containing serous fluid. Lymphangiomas were located in the retroperitoneal space (3 cases), in the mesenteric bed (3 cases), close to the left lumbar ureter (1 case), and on the left colon wall (1 case); the symptoms were little characteristic, mostly due to pressure on the adjacent organs. Both CT and US were able to detect and evaluate the lesions; in particular, CT provided also with exact topography. A small lymphangioma in the left colon was revealed only by barium enema. In 2 huge retroperitoneal lymphangiomas the diagnostic evaluation was improved by the use of CT-guided fine-needle biopsy; in patients with mesenteric lesions angiography was employed, also for surgical planning. Lymphography was never performed because CT and US proved the best diagnostic procedures. All patients underwent surgery, whose results confirmed the previous diagnosis, but for the patient with para-ureteral location the surgeon thought nephrectomy necessary.     

纵隔囊性病变的CT诊断及鉴别诊断

目的探讨纵隔囊性病变的CT诊断及鉴别诊断.方法本组共12例,均经手术及病理证实,男9例,女3例,年龄17～55岁.12例均行CT平扫,其中5例行CT增强扫描.回顾性分析其CT表现.结果纵隔囊性病变中,胸腺囊肿3例,淋巴管瘤2例,支气管囊肿7例.3例胸腺囊肿中,2例位于前纵隔,1例位于左颈及前纵隔;2例淋巴管瘤,1例位于中纵隔,1例位于左颈及前、中纵隔.7例支气管囊肿,均位于中纵隔气管及支气管右旁区域.结论CT平扫结合增强扫描,不仅准确显示纵隔囊性病变的位置和形态,而且清楚显示其与邻近结构的关系,因此结合临床资料及发病部位,对于纵隔囊性病变一般能够达到术前定性诊断.     

纵隔囊性淋巴管瘤的X线及CT诊断探讨

目的　探讨纵隔囊性淋巴管瘤 (CLM)X线和CT诊断。方法　回顾分析 10例CLM的胸部平片及其中 8例CT表现。结果　根据肿块发生部位 ,颈纵隔型 3例 ,纵隔型 7例。位于前纵隔 7例 ,后纵隔 2例 ,累及纵隔多区域及胸腔 1例。 8例位于中上纵隔或胸廓入口 ,胸片多数表现边缘光整的纵隔肿块 ,无纵隔移位 ;CT显示肿块为囊性 ,边界清晰 ,无周围侵犯 ,颈纵隔型CLG的纵隔肿块与颈部肿块贯通。结论　CLM多发生于前纵隔及中上纵隔 ,颈纵隔型CLG根据胸部影像表现及体征可以确诊 ,纵隔型CLG诊断需与纵隔其他囊性占位鉴别。     

Retrorectal developmental cysts in adults: clinical and radiologic-histopathologic review, differential diagnosis, and treatment.

Developmental cysts are the most common retrorectal cystic lesions in adults, occurring mostly in middle-aged women. They are classified as epidermoid cysts, dermoid cysts, enteric cysts (tailgut cysts and cystic rectal duplication), and neurenteric cysts according to their origin and histopathologic features. Although developmental cysts are often asymptomatic, patients may present with symptoms resulting from local mass effect (eg, constipation, rectal fullness, lower abdominal pain, dysuria), with a palpable retrorectal mass at digital rectal examination, or with a complication. Infection with fistulization, bleeding, and malignant degeneration are the major complications of developmental cysts. A well-defined, unilocular or multilocular, thin-walled cystic lesion is the main imaging feature. Uncommonly, a sacral bone defect and calcifications are associated with developmental cysts. The differential diagnosis includes cystic sacrococcygeal teratoma, anterior sacral meningocele, anal duct or gland cyst, necrotic rectal leiomyosarcoma, extraperitoneal adenomucinosis, cystic lymphangioma, pyogenic abscess, neurogenic cyst, and necrotic sacral chordoma. Complete surgical excision is indicated to establish the diagnosis and avoid complications.     

脾脏肿瘤的影像分析

目的探讨脾脏肿瘤的临床、影像学表现,提出诊断与鉴别诊断的要点。方法回顾分析了21例经手术病理证实的脾脏肿瘤临床特点及影像学特征。结果脾炎性假瘤呈单发灶,密度不均匀,可有钙化;血管瘤为实性肿块或多囊性肿块,不均匀强化;淋巴管瘤特点为多发低密度灶;恶性淋巴瘤在脾内为单发或多发灶;脾的转移瘤表现多种多样。结论认真分析影像学特征,提高脾脏肿瘤诊断的准确率是可能的。     

Mesenteric cysts in the adult

The authors describe five cases of mesenteric cysts evaluated by ultrasonography and computed tomography: 3 cases of cystic lymphangioma, 1 vestigial serous cyst, 1 dermoid cyst. Ultrasonography is useful for analyzing the contents of these lesions, and must be utilized to search for possible pelvic anomalies, allowing diagnosis of pendunculated ovarian cysts for example. CT offers better sensitivity for evaluating the effect of such cysts on neighboring viscera and particularly on the intestine. CT is also better for identification of the fatty components indicative of dermoid or chylous cysts. These rare tumors are almost always benign, and a combined modality imaging approach based on ultrasound and CT suffices for diagnosis.     

腹部巨大囊性病变CT诊断

目的：探讨腹部巨大囊性病变的ＣＴ诊断和鉴别诊断要点。方法：腹部巨大囊性病变３０例,均经手术病理证实,分析其病变中心点、边界、囊壁、分隔、钙化、液平征、强化等要素。结果：中下腹包块１４便,有１５个包块。其中：卵巢浆液性囊腺瘤４例,５个包块。粘液性囊腺瘤３例,卵巢囊肿１例,卵巢－输卵管炎性囊肿１例,巨大膀胱憩室１例,成熟性囊性畸胎瘤４例;中上腹包块１３例,其中：囊性淋巴管瘤５例,和重复畸形囊肿２例,小     

淋巴管瘤影像学诊断

目的:探讨淋巴管瘤的影像学表现,评价影像学的诊断价值.方法:回顾性分析31例经手术及病理证实的淋巴管瘤影像学资料.结果:根据所合淋巴管扩张程度不同,组织学上将其分为3型:囊性淋巴管瘤18例、海绵状淋巴管瘤11例和血管瘤淋巴管瘤2例.结论:CT和MRI检查可清晰显示淋巴管瘤的大小、形态和范围,具有重要的诊断价值,MRI在...     

Hemorrhagic mesenteric cystic lymphangioma presenting with acute lower abdominal pain: the diagnostic clues on MR Imaging

A 32-year-old woman complained of acute lower abdominal pain. Computed tomography showed a complex multilocular cystic mass at the right adnexal region. Magnetic resonance imaging demonstrated the origin of the mass to be the small bowel mesentery. Chemical-shift images detected septal fat of the cystic mass and suggested a small amount of fat within the locules of the cyst. A cystic tumor of the mesentery such as cystic lymphangioma, hemangioma, cystic mesothelioma, and dermoid was included in the differential diagnoses. The diagnosis of a hemorrhagic mesenteric cystic lymphangioma was confirmed at surgery and pathologic analysis. Cystic lymphangioma should be included in the differential diagnosis of acute abdominal pain. The detection of septal fat may be helpful in the diagnosis of cystic lymphangioma when it shows unusual radiological appearances.