Wu Lei-Di, Wen Kan, Cheng Zi-Rui, Alwalid Osamah, Han Ping
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China.
Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China.
World J Clin Cases. 2021 Aug 26;9(24):7245-7250. doi: 10.12998/wjcc.v9.i24.7245.
Bronchogenic cysts (BCs) are benign congenital foregut malformations that are mostly present in the mediastinum and pulmonary parenchyma but rarely seen in the retroperitoneum.
We report the case of 17-year-old girl who complained of epigastric pain. A cystic lesion was found in the left suprarenal region on spectral computed tomography. The ovoid, well-defined, and homogeneous cystic lesion revealed slightly enhancement on conventional imaging but no enhancement on 40 KeV virtual mono-energetic images. The iodine density value of the lesion was 0.001 mg/mL and the Z-effective value was 7.25, which were close to those of fluid material in experiments. Magnetic resonance imaging revealed a cystic mass of intermediate signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging. A laparoscopic surgery was carried out. Intraoperatively, a cystic lesion with a smooth surface was found in the left retroperitoneum. And the cystic wall was completely resected after intracystic fluid was suctioned. The histopathological examination findings of the lesion were compatible with BC. The patient recovered uneventfully without sighs of recurrence during a 10-mo follow-up period.
Radiological examinations play a significant role in the diagnosis of suprarenal BCs and spectral images offer additional spectral parameters. Accurate preoperative diagnoses of retroperitoneal BCs based on thorough imaging examinations are beneficial to the operation of laparoscopic resection.
支气管源性囊肿（BCs）是良性先天性前肠畸形，大多位于纵隔和肺实质，而在腹膜后罕见。
我们报告一例17岁女性患者，主诉上腹部疼痛。光谱计算机断层扫描显示左肾上腺区域有一个囊性病变。该椭圆形、边界清晰且均匀的囊性病变在传统成像上有轻微强化，但在40 keV虚拟单能图像上无强化。病变的碘密度值为0.001 mg/mL，有效原子序数为7.25，与实验中液体物质的这些值相近。磁共振成像显示在T1加权成像上为中等信号强度的囊性肿块，在T2加权成像上为高信号强度。进行了腹腔镜手术。术中，在左腹膜后发现一个表面光滑的囊性病变。吸出囊内液体后完整切除了囊壁。病变的组织病理学检查结果与支气管源性囊肿相符。患者恢复顺利，在10个月的随访期内无复发迹象。
放射学检查在肾上腺支气管源性囊肿的诊断中起重要作用，光谱图像提供了额外的光谱参数。基于全面的影像学检查对腹膜后支气管源性囊肿进行准确的术前诊断有利于腹腔镜切除术的操作。
