摘要
目的:小儿腹部淋巴管瘤少见,分析小儿腹部淋巴管瘤的CT影像学表现,探讨CT对小儿腹部淋巴管瘤的诊断价值。材料与方法:收集中国医科大学附属盛京医院5年来(2007年2月—2012年2月)经病理证实为腹部淋巴管瘤的患儿共32例(男17例,女15例;年龄2-14岁,平均6岁),所有患儿均行腹部CT扫描(平扫4例,增强28例),其中4例患者同时行腹部增强MR扫描。分析其影像学表现,归纳其影像学特征。结果:病理上32例腹部淋巴管瘤分别起源于肠系膜(n=17)、大网膜(n=9)、腹膜后(n=4)及腹腔内不明来源(n=2)。CT图像上瘤体位于右侧腹部者16例、位于左侧腹部者7例、居中者4例,其余5例患者肿瘤占据全腹部,病理上均起源于大网膜。CT诊断为淋巴管瘤18例、肠系膜或大网膜囊肿4例、肠系膜恶性肿瘤1例、卵巢肿瘤2例、畸胎瘤2例、胰腺囊腺瘤1例、肠重复畸形1例、未确诊2例、漏诊1例。淋巴管瘤的CT影像学特征为较大囊性占位,其中绝大多数肿瘤短径≥5 cm(30/32),呈多囊分叶状并有多发间隔(32/32),多数囊壁及间隔较薄(27/32),具有沿肠间隙"填充式"或"包绕式"生长的特点(30/32),囊内呈澄清低密度(31/32),极少见实性成分(1/32)、极少见出血(2/32)、极少见囊壁及间隔钙化(1/32)。增强扫描囊壁及间隔均有明显强化(28/28)。部分肿瘤内部可见肠管穿行(11/32),增强扫描多数肿瘤内部可见血管穿行(24/28)。结论:CT对小儿腹部淋巴管瘤的检出率及确诊率均较高,具有特征性的影像学表现,是小儿腹部淋巴管瘤的最佳检查选择之一。
Objective： Intra-abdominal lymphangioma is very rare and comprises less than 5% of all lymphangiomas.The aim of this study is to discuss the CT findings of intra-abdominal lymphangioma in children.Materials and Methods： A database of 32 pediatric patients（17 males and 15 females,aged from 2 to 14 years old） with intra-abdominal lymphangioma proved by pathology in Shengjing Hospital from Feb.2007 to Feb.2012 was reviewed.CT scan had been performed in all cases,including 28 patients who also had enhanced CT scans.MR had been performed in 4 cases.The CT findings of all cases were reviewed to summarize the CT features of intra-abdominal lymphangioma.Results： In pathology,the tumors originated from mesentery（n=17）,omentum（n=9）,retroperitoneal space（n=4）,and uncertain tissues（n=2） respectively.In CT images,the lesions located in the right side（n=16）,the left side（n=7）,the middle（n=4）,and the whole abdomen（n=5） respectively.Five lesions which located in the whole abdomin all originated from omentum.The lesions were diagnosed as lymphangioma（n=18）,cyst（n=4）,mesenteric malignant mass（n=1）,ovarian tumor（n=2）,teratoma（n=2）,pancreatic cystadenoma（n=1）,duplication of intestine（n=1）,and uncertain disease（n=2） based on CT findings,and omission occured in 1 case.Lymphangioma usually appeared in the CT images as a scrotiform tumor with wall and septa（32/32） which could be enhanced significantly after injection of contrast.Most of the wall and septa were thin（27/32） and the contents of the tumors were almost clean fluid（31/32）,solid content（1/32）,bleeding（2/32）,and calcification（1/32） were rarely seen.This kind of tumor often grew through or around the adjacent tissue and organ,including fat（15/32）,small bowels（11/32）,and vessels（24/28） in our study.Conclusion： CT is very helpful in finding the lesion and making a definite diagnosis of intra-abdominal lymphangioma in children,which is one of the best choice of examination.
出处
《中国临床医学影像杂志》
CAS
2013年第7期485-488,492,共5页
Journal of China Clinic Medical Imaging
