Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510080, PR China.
Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China.
Eur J Radiol. 2020 May;126:108905. doi: 10.1016/j.ejrad.2020.108905. Epub 2020 Feb 28.
To analyze the imaging manifestations of mediastinal hemangioma (MH) by CT and MRI to aid in its successful diagnosis and preoperative evaluation.
Seventeen cases of MH diagnosed by histopathology combined with CT and MRI were retrospectively collected; and their CT and MRI features, including the lesions' site and range, shape, size, margin, density or signal, enhancement pattern, mass-cardiovascular interface, mass-pulmonary interface, and other characteristics were evaluated.
The anterior, middle, and posterior mediastinum were involved in 13, 13, and 8 cases, respectively. The masses size varied from 20 to 233 mm. Irregular, dumbbell-like, and oval masses were found in 13, 2, and 2 cases, respectively, while with pampiniform growth in 16 cases and expansive growth in 1 case. Mixed density, homogeneous density solid masses, and heterogeneous density masses with dominant fat were found in 9, 5, and 3 cases, respectively, showing mild or significant enhancement in aortic phase while no or mild enhancement in pulmonary artery phase. Draining veins were found in 16 cases and feeding arteries in 10 cases. Phleboliths were detected in 10 cases, splenic hemangiomas in 6 cases, and left lateral-chest-wall hemangioma in 1 case. In MRI sequences, mixed signal was found on TWI and heterogeneous hypersignal with nodular or linear hyposignal on TWI in 5 cases, mild or significant enhancement in 4 cases, draining veins in 2 cases, and no feeding arteries or phleboliths were seen.
Presence of phleboliths, pampiniform growth pattern, and aberrant draining veins are relatively specific characteristics in diagnosing MH.
分析纵隔血管瘤（MH）的 CT 和 MRI 影像学表现，以辅助其成功诊断和术前评估。
回顾性收集了 17 例经组织病理学结合 CT 和 MRI 诊断为 MH 的病例；评估了 CT 和 MRI 特征，包括病变部位和范围、形状、大小、边缘、密度或信号、强化模式、肿块与心血管界面、肿块与肺界面以及其他特征。
前、中、后纵隔分别受累 13、13 和 8 例。肿块大小从 20 至 233mm 不等。13 例为不规则形、哑铃形和椭圆形肿块，2 例为类圆形肿块，2 例为纺锤形生长，1 例为膨胀性生长。9 例为混杂密度实性肿块，5 例为均匀密度实性肿块，3 例为混杂密度为主的含脂肪肿块，主动脉期呈轻至明显强化，肺动脉期呈无或轻度强化。16 例可见引流静脉，10 例可见供血动脉。10 例可见静脉石，6 例可见脾血管瘤，1 例可见左侧胸壁血管瘤。MRI 序列上，5 例 T1WI 呈混杂信号，T2WI 呈混杂高信号，结节状或线状低信号，4 例呈轻至明显强化，2 例可见引流静脉，未见供血动脉或静脉石。
静脉石、纺锤形生长模式和异常引流静脉是诊断 MH 的相对特异性特征。
