纵隔包虫病CT及CMR表现并文献复习

目的 探讨纵隔包虫病的影像特点及鉴别诊断。 方法 回顾性分析1例经临床证实的纵隔包虫病CT和心脏MR表现并进行文献复习。 结果 CT平扫显示右侧冠状沟类圆形囊状稍低密度,密度均匀,局部壁钙化,右侧房室交界部及右冠状动脉近段受压推移。 心脏MR显示病灶T₁WI呈等信号,T₂WI黑血序列呈稍高信号,电影序列示右房、右室运动及三尖瓣开放受限,病灶随房室运动轻度抖动,T₁ mapping显示腔内信号均匀。静息首过灌注及延迟增强影像均显示病灶未见明显强化。 结论 纵隔包虫病较为罕见,诊断时应结合其流行病学史、CT和MRI的影像特点,临床工作中诊断纵隔囊性占位也应考虑到纵隔包虫病感染的可能。

CT and CMR manifestations of mediastinal hydatid disease and literature review

Objective To investigate the imaging characteristics and differential diagnosis of mediastinal hydatid disease. Methods The CT and CMR of a patient with clinically confirmed mediastinal hydatid disease manifestations was retrospectively analyzed, and literatures were reviewed. Results CT plain scan showed that a homogeneous mild hypodense cystic lesion with partial wall calcification in the right coronary sulcus. The right atrioventricular junction and the proximal right coronary artery were compressed. CMR showed that the lesion was isointensity on T₁WI, mild hyperintensity on black blood sequence of T₂WI, the movement of the right atrium and right ventricle and the opening of the tricuspid valve were restricted and the lesions jittered slightly with atrioventricular movement on movie sequence, and homogeneous intracavitary signals on T₁ mapping. Both first-pass perfusion and delayed-enhanced images showed the lesion had no obvious enhancement. Conclusion Mediastinal echinococcosis is relatively rare. The epidemiological history and imaging characteristics should be combined in the diagnosis. The mediastinal echinococcosis should also be considered in the diagnosis of mediastinal cystic lesions in clinical work.