摘要
目的：分析肝脏淋巴瘤的多层螺旋CT（MSCT）表现，以提高其诊断水平。方法：回顾性分析8例经病理或临床治疗随访证实的肝脏淋巴瘤的MSCT表现。结果：8例肿瘤中继发淋巴瘤6例，原发2例；单发4例，多发4例；6例位于门静脉左右分支邻近或汇管区，2例位于肝脏周边，平扫呈相对低或稍低密度，CT值约18.8~32.1HU；3例呈单发圆形或椭圆形肿块，4例多发肿块，1例呈左叶弥漫多发斑片状结节。其中4例肿块型边界较清晰，其余4例肿瘤边界均较模糊，2例胆管轻度局限扩张。增强扫描肿瘤6例动脉期呈轻－中度强化，较正常肝组织强化弱，仅2例较正常肝组织强化稍强，8例门脉期强化均略加强，但仍明显弱于正常肝组织，延迟期强化减弱。6例肿瘤中见血管走行，类似“血管漂浮征”，但血管局部轻度受压变窄。6例见腹腔或腹膜后肿大淋巴结，大小不均匀，呈轻－中度强化，强化相对均匀，未见明显坏死，所有肿瘤未见钙化，坏死不明显。结论：肝脏淋巴瘤可单发或多发，常位于门静脉左右支邻近或位于汇管区，少见坏死区，CT平扫密度相对均匀；增强强化相对均匀，呈轻-中度延迟强化，部分病灶内可见类似“血管漂浮征”。MSCT能较清晰显示肿瘤的部位、数目、形态及血供情况、周边组织器官改变等，对肝脏淋巴瘤的诊断有较大价值。
Abstract
Objective: To analyse the multi-slice spiral CT(MSCT) appearances of hepatic lymphoma, and improve its diagnostic accuracy. Methods: Eight cases of MSCT findings with hepatic lymphoma were reviewed which were proved by pathology or clinical follow up. Results: There were 6 cases of secondary lymphoma, and 2 cases of primary lymphoma. In the 8 cases 3 cases with single focus, 5 cases with multi-foci, in 6 cases the lesion located near the branch of portal vein or converge area, in 2 cases the lesion located in the border of liver. The foci showed low density on plain scan, CT value were 18.8~32.1HU; in 3 cases the lesion appeared as round or oval, 4 cases were multi-irregular tumors, and 1 case appeared as diffused with multi-speckled nodules in left lobe of liver. 4 cases tumors had clear edge, the other 4 cases with dim edge. 2 cases with local dilation of bile duct. In contrast enhancement, 6 cases intensified slightly in arterial phase and the intensity was lower than normal tissue, 2 cases intensified obviously in arterial phase, the density was higher than normal tissue, 8 cases with continued enhancement in portal vein-phase, but were fainter than normal tissue, in delayed phase, the enhancement of tumor decreased, blood vessels were seen within the lesion in 6 cases as “blood vessel floating-sign”, the vessel was compressed. Six cases had enlarged retroperitoneal lymph-nodes with different sizes, slightly to moderate homogeneous enhancement, and without obvious necrosis. Calcification and necrosis were not be seen in all tumors. Conclusion: Hepatic lymphoma can be single or multiple tumor, located near the branch of portal vein or its supplied area, without obvious necrosis, CT showed homogeneous density on plain scan, and with slightly to moderate homogeneous enhancement. Some tumors showed “blood vessel floating-sign”. MSCT can show the position, number, shape of tumor and the blood supply clearly and the change of adjacent tissue and organ, is useful for the diagnosis of hepatic lymphoma.
关键词
肝肿瘤 /
淋巴瘤 /
体层摄影术 /
螺旋计算机
Key words
Liver neoplasms /
Lymphoma /
Tomography /
spiral computed
吴建明;马周鹏;章顺壮;周建军.
MSCT动态增强扫描对肝脏淋巴瘤的诊断分析[J]. 中国临床医学影像杂志. 2011, 22(5): 312-315
WU Jian-ming;MA Zhou-peng;ZHANG Shun-zhuang;ZHOU Jian-jun.
Diagnosis of dynamic enhanced MSCT in hepatic lymphoma[J]. Journal of China Clinic Medical Imaging. 2011, 22(5): 312-315
中图分类号：
Ｒ735.7
Ｒ730.263
R814.42
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