Abstract
BackgroundThe cavernous hemangioma of mediastinum (CHM) is a rare benign lesion caused by congenital vascular dysplasia. However, its incidence is extremely low, and patients often lack relevant clinical symptoms. So we analyzed retrospectively some cases to investigate the imaging features of cavernous hemangioma of mediastinum (CHM) and improve the diagnostic accuracy.MethodsThe CT/MRI imaging features and clinical information of 19 patients with CHM were analyzed retrospectively.ResultsThe lesions of 18 CHM patients were single. Twelve cases in the anterior mediastinum and 8 in the posterior mediastinum. The diameter of CHM ranges from 2.0 to 7.0 cm. Thirteen cases were oval-shaped or round, 4 cases were lobulated, and 2 cases were irregular. Phleboliths or nodular calcification were identified in four cases. High signal of T2WI lipid suppression in two cases and blood vessel shadows were observed in two cases. After contrast-enhanced scan, the nodular enhancement of arteries were identified in 14 cases and contrast agent was further filled of the venous phase, where “fast in and slow out” feature was performed. One case showed inhomogeneous enhancement, one case performed “fast in and slow out” feature of multiphase-enhanced MRI. Besides, aberrant veins can be seen in or around the lesion among five cases.ConclusionsCHM is more frequently located at the anterior mediastinum than at the posterior mediastinum. The performance of phleboliths, high signal on T2WI fat suppression and DWI, the nodular enhancement of the artery, venous and delayed phase filling, enhanced “fast in and slow out,” and aberrant veins in the lesion are helpful for the diagnosis and differential diagnosis. Multiple period contrast-enhanced CT and MRI scan is helpful for the diagnosis of CHM.
Highlights
The cavernous hemangioma of mediastinum (CHM) is a rare disease of mediastinal benign lesions that originates from isolated embryonic simple angioblast tissue or vascular dysplasia, which is composed of masses with varying sizes and dilated cavernous sinus pathologically
Its incidence rate is below 0.5% in mediastinal lesions from some literatures [1] and patients often lack of relevant clinical symptoms [1]
Five cases in the anterior mediastinum revealed aberrant draining veins that antidromic filled by contrast agent after enhanced scanning (Fig. 1 (4))
Summary
The cavernous hemangioma of mediastinum (CHM) is a rare disease of mediastinal benign lesions that originates from isolated embryonic simple angioblast tissue or vascular dysplasia, which is composed of masses with varying sizes and dilated cavernous sinus pathologically. Its incidence rate is below 0.5% in mediastinal lesions from some literatures [1] and patients often lack of relevant clinical symptoms [1]. The image manifestation is diverse and the rate of misdiagnosis before. The cavernous hemangioma of mediastinum (CHM) is a rare benign lesion caused by congenital vascular dysplasia. Its incidence is extremely low, and patients often lack relevant clinical symptoms. We analyzed retrospectively some cases to investigate the imaging features of cavernous hemangioma of mediastinum (CHM) and improve the diagnostic accuracy
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