Abstract:
As the majority of incidentally detected lesions in the anterior mediastinum is small nodules with soft tissue appearance, the differential diagnosis has typically included thymic neoplasm and prevascular lymph node, with benign cyst. Overestimation or misinterpretation of these lesions can lead to unnecessary surgery for ultimately benign conditions. nonsurgical anterior mediastinal lesions. The pitfalls of MRI evaluation for anterior mediastinal cystic lesions are as follows: first, we acknowledge the limitation of T2-weighted images for evaluating benign cystic lesions. Due to variable contents within benign cystic lesions, such as hemorrhage, T2 signal intensity may be variable. Second, owing to extensive necrosis and cystic changes, the T2 shine-through effect may be seen on diffusion-weighted images (DWI), and small solid portions might be missed on enhanced images. Therefore, both enhancement and DWI with apparent diffusion coefficient values should be considered. An algorithm will be suggested for the diagnostic evaluation of anterior mediastinal cystic lesions, and finally, a management strategy based on MRI features will be suggested.
摘要:
由于前纵隔中偶然发现的大多数病变是具有软组织外观的小结节,鉴别诊断通常包括胸腺肿瘤和血管前淋巴结,良性囊肿.对这些病变的高估或误解可能导致最终良性疾病的不必要手术。非手术前纵隔病变。MRI评价前纵隔囊性病变的缺陷如下:第一,我们认识到T2加权图像用于评估良性囊性病变的局限性.由于良性囊性病变内内容可变,比如出血,T2信号强度可以是可变的。第二,由于广泛的坏死和囊性改变,T2穿透效应可以在扩散加权图像(DWI)上看到,和小的固体部分可能会错过增强的图像。因此,应考虑具有表观扩散系数值的增强和DWI。将建议一种算法用于前纵隔囊性病变的诊断评估,最后,将提出基于MRI特征的管理策略.