Atypical Computed Tomography and Magnetic Resonance Imaging Findings of Posterior Inferior Mediastinal Bronchogenic Cysts: A Clinical Case Analysis
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摘要:
纵隔型支气管囊肿（MBC）是一种先天性支气管囊肿，多发生于中纵隔中上部，发生在后下纵隔相对少见。本文报道1例后下纵隔支气管囊肿患者，19岁，男性，体检发现纵隔占位。CT表现为后下纵隔脊柱旁不规则肿块，密度混杂，边缘及内部可见结节状钙化，增强后未见强化。MRI检查T1WI呈不均匀低信号，T2WI呈高信号，内见条索状、分隔样低信号，增强后延迟期病灶边缘及分隔轻度强化。术后病理诊断：支气管源性囊肿。本文回顾性分析该病例的CT和MRI影像特征，并复习国内外文献，总结后下纵隔不典型支气管囊肿的影像表现，以提高对该疾病的认识。
Abstract:Mediastinal bronchial cysts (MBCs) are congenital bronchial cysts (CBCs) that mostly occur in the middle and upper mediastinum and rarely in the posterior inferior mediastinum. A case of posterior MBC was reported in a 19-year-old male patient with mediastinal space occupancy on physical examination. Computed tomography (CT) showed an irregular mass near the spine of the posterior inferior mediastinum, which was of mixed density, with nodular calcification at the edge and inside, and no enhancement. Magnetic resonance imaging (MRI) showed heterogeneous hyperintensity on T1-weighted imaging (T1WI) and hyperintensity on T2WI, which were internal to the cord like appearance and showed septation-like hypointensity, mild enhancement of the lesion edge, and septation in the delayed phase after enhancement. The postoperative pathological diagnosis was bronchogenic cyst. In this report retrospectively reviewed the CT and MRI imaging features of this case, as well as those described in the domestic and foreign literature to summarize the imaging findings of atypical bronchocysts in the posterior lower mediastinum to improve the understanding of this disease.
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图 1 后下纵隔支气管囊肿CT图像
Figure 1. CT images of a patient with posterior inferior mediastinal bronchogenic cysts
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图 2 后下纵隔支气管囊肿MR图像
（a）横断面TSE FS T2WI显示病变呈高信号，内见分隔样低信号；（b）横断面FS T1WI显示病变呈不均匀低信号；（c）～（d）横断面DWI呈不均匀高信号，ADC图未见扩散受限；（e）冠状面TSE T2WI显示病变位于脊柱左旁，其上方见条状液性信号；（f）横断面增强T1WI动脉期，病变未见强化其他（g）～（h）横断面、冠状面增强T1WI延迟期，病变囊壁及内部分隔强化。
Figure 2. MR images of a patient with posterior inferior mediastinal bronchogenic cysts
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图 3 后下纵隔支气管囊肿病理图像
Figure 3. Pathological images of a patient with posterior inferior mediastinal bronchogenic cysts
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