酷似纵隔肿块的食道静脉曲张的影像学诊断

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1、酷似纵隔肿块的食道静脉曲张的影像学诊断酷似纵隔肿块的食道静脉曲张的影像学诊断【摘要】目的:探讨酷似纵隔肿块的食道周围型静脉曲张的影像诊断。方法：自2005-2007年我院18例酷似纵隔肿块的食道静脉曲张在CT或MRI检查中诊断为食道静脉曲张，其中11例最终经手术或DSA证实为食道静脉曲张。回顾性分析此18例患者的影像学表现。结果：18例患者DR检查均见大小不等的后下纵隔肿块，增强CT或MRI检查中表现为静脉期食管壁及食管周围显著强化的迂曲血管团。11例患者中病变的CT或MRI表现与DSA或纵隔手术表现完全相符合，并可清楚显示流入和流出血管。结论:CT及MRI检查可正确诊断酷似纵隔肿块的食

2、道静脉曲张,避免盲目活检造成的致命性出血。❷【关键词】门静脉;食道;静脉曲张;肿块;CT;MRI;DR❷doi:10.3969/j.issn.1006-1959.2010.09.426文章编号:1006-1959(2010)-09-2646-02❷DentificationofEsophagealVaricesSimilartoMediastinalmass:imagingdiagnosisDONGYun-xu,QINJie,MENGXiao-chun,ZHANGJian-shenDepartmentofRadiology,theThirdAffiliatedHospital,SunYa

3、t-senUniversity,Guangzhou510630,China❷[Abstract]0bjective:Toanalyzetheimagingdiagnosisofesophagealvaricessimilartomediastinalmass・Methods:From2005to2007,high-densitymass-likeshadowinmediastinalspace,whichwasdetectedinDRexaminations,wasdiagnosedasesophagealvaricesbyCTorMRIexaminationsin18patients.

4、Amongthem,11patientswerefinallyconfirmedbyDSAormediastinaloperation.Theimagingfeaturesofthese18patientswereretrospectivelyanalyzed・Results:Allpatientspresentedhigh-densitymass-likeshadowinposteriorinferiormediastinuminDRimageswithdifferentsizes・Incontrast-enhancedCTorMRIexaminations,alltheselesio

5、nsappearedasremarkablydilatedtortuousbloodvesselsinoraroundesophagealwallwithsignificantenhancementinportalvenousphase,whichconnectedwiththeportalvenousbranches・InCTorMRIexaminations,theflow-inandflow-outvesselswereclearlydepictedinallofthem・ThemanifestationsofthevaricespresentedinCTorMRIexaminat

6、ionswerefinallyconfirmedinDSAormediastinaloperationsin11patients・Cone1usion:Esophagealvaricessimilartomediastinalmasscanbecorrectlyidentifiedbyun-invasiveCTorMRIexaminationandavoidedfetalbleedingduetoblindedbiopsy.❷[Keywords】Esophagealvarices;Mediastina.lmass;Computedtomography:MagnaticResonanceI

7、maging;CT;MRI;DR食道胃底静脉曲张作为门静脉高压的表现之一，诊断并不困难，上消化道内镜或顿餐可直接或间接的观察到粘膜面扩张迂曲的血管，这已有众多的文献描述并为人们所熟知,本文不再赘述，而表现为酷似纵隔肿块的食道周围型静脉曲张的影像诊断文献报告基少,偶可引起误诊(迷惑)，本文重点探讨这一较少见的静脉曲张类型。❷1.资料与方法❷1.1一般资料:本组18例，男12例，女6例,年龄25-72岁,平均48岁。所有病例均有慢性乙肝