淋巴管瘤的磁共振成像诊断

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1、骨骼肌肉影像学一155一MUSCULOSKELETALlMAGING淋巴管瘤的磁共振成像诊断马立恒’张朝晖陈应明孟悛非肖萍【摘要】目的：探讨淋巴管瘤不同病理学类型的磁共振表现特点以及鉴别诊断。方法：回顾性分析44例经手术病理证实为淋巴管瘤的MRI检查资料，所有病例均行矢、冠、轴三平面扫描，其中30例于MRI平扫后行常规增强扫描。以病理学所见为参照，分析各病理类型淋巴管瘤的MRI表现特点并统计分析不同病理类型淋巴管瘤发生部位的差异。MRI征象分析包括：病变的形态、累及范围、有无包绕血管、内部信号特点、有无分房、分隔

2、厚薄情况及强化特征。结果：MRI上淋巴管瘤的形态多为不规则状(38／44)，边界不清(30／44)，部分见血管包绕征(17／44)，较大者产生占位效应。不同病理类型的淋巴管瘤发生部位的差异无显著性。与邻近肌肉组织相比，24个(54．5％)病变表现为T．WI上等或高信号、TwI上更高信号区，较具特征。囊状淋巴管瘤31例，病变内可见液一液平面，分房大，分隔细、薄，增强扫描呈轻度或无强化；海绵状淋巴管瘤7例，表现为分房多，大小不一，分隔厚或有乳头状突起，增强扫描显示分隔及乳头明显强化；血管淋巴管瘤6例，MR表现为分房大

3、小不一，分隔厚薄不一，内未见液一液平面，增强扫描囊壁及分隔明显强化，难与海绵状淋巴管瘤鉴别。结论：淋巴管瘤不同病理学类型的MRI表现有一定特点，MRI对于鉴别囊状淋巴管瘤与其他两类较具价值，而海绵状淋巴管瘤有时难以与血管淋巴管瘤鉴别。【关键词】淋巴管瘤；磁共振成像中图分类号：R733文献标志码：A文章编号：1006—5741(2011)一02—0155—05MRIDiagnosisofLymphangiomaMALi一8他，ZHANGZhao—hui2，CHENYing—m舰，MENGQuan一r，XIAOp￡舰

4、．【Abstract】Purpose：ToinvestigatethecharacteristicsanddiferentialdiagnosisofdifferentpathologictypesoflymphangiomaonMRI．Methods：TheMRIimagesoflymphangiomain44patientsconfirmedbypathologywereanalyzedretrospectively．Alllesionswerescannedintransverse．coronaryands

5、agitalplan．30patientswereperformedcontrastenhancementMRIafterplainscan．Comparedwiththecorre-spondinghistopathologicfindings，theappearancesofMRIofdifferentpathologictypesoflymphangiomawereanalyzed．Thedistributiondifferencesofthedifferentpathologictypesoflympha

6、ngiomawerean‘alyzed．ThefeaturesanalyzedonMRimagesincludedtheshapeandextentofthelesions，theencasementofvessels，thesignalintensityinlesions，unilocularormultilocular，thethicknessoftheseptaandthecharacteristicsofcontrastenhancement．Results：OnMRimages，thelymphanig

7、omaappearedasirregu—lar(38／44)，ill—defined(30／44)，andvesselencasementsigns(17／44)inlesions．Somelargelesionspro-ducedspace—occupyingeffect．Therewasnostatisticdifferenceinthedistributionofthedifferentpathologictypesoflymphangioma．Comparedwiththeadjacentmuscles，

8、24(54．5％)lesionsappearedasisointenstiyorhyperintensity(24／44)onT1WIandmoredistincthyperintensityonT2wI．Thirty—onelesionswereconfirmedascysticlymphangiomapathologicallywhichdemonstratedcys