Fuyuno G, Kobayashi R, Iga R, Nomori H, Kodera K, Morinaga S
Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Oct;32(10):1038-42.
We present two cases of pericardial cyst diagnosed by cyst puncture and the injection of contrast medium. The first patient was a 48-year-old man. He was admitted for the evaluation of an abnormal chest X-ray which demonstrated a mass lesion inseparable from the right heart border. CT scan confirmed the mass in the anterior cardiophrenic angle. The mass was quite homogeneous, with an attenuation value of -0.3 HU. Under CT guidance a 21-G needle was inserted into the cyst and 3 ml of clear fluid was obtained, and then contrast medium was injected. A thin smooth walled cyst was outlined by the CT scan. A presumptive diagnosis of pericardial cyst was made. Surgery was performed and the diagnosis was confirmed. The second patient was a 24-year-old woman. An abnormal shadow was noted at annual check up. CT scan confirmed the mass in the anterior cardiophrenic angle. The mass was quite homogeneous, with an attenuation value of +10.4 HY. We made the diagnosis of pericardial cyst by cyst puncture and injection of contrast medium. The CT scan after three months showed no recurrence of the pericardial cyst. We consider that pericardial cyst can be diagnosed clearly by cyst puncture and the injection of contrast medium, and only percutaneous aspiration of the cyst fluid may be sufficient for the treatment.
我们报告两例通过囊肿穿刺和注入造影剂诊断的心包囊肿病例。首例患者为一名48岁男性。他因胸部X线检查异常入院，X线显示一肿块病变与右心缘相连。CT扫描证实肿块位于心膈角前方。肿块密度相当均匀，衰减值为-0.3 HU。在CT引导下，将一根21G的针插入囊肿，抽出3 ml清亮液体，然后注入造影剂。CT扫描勾勒出一个薄壁光滑的囊肿。初步诊断为心包囊肿。随后进行手术，确诊。第二例患者是一名24岁女性。年度体检时发现异常阴影。CT扫描证实肿块位于心膈角前方。肿块密度相当均匀，衰减值为+10.4 HY。我们通过囊肿穿刺和注入造影剂诊断为心包囊肿。三个月后的CT扫描显示心包囊肿无复发。我们认为，通过囊肿穿刺和注入造影剂可以明确诊断心包囊肿，仅经皮抽吸囊液可能就足以治疗。
