原发性胃肠道淋巴瘤64排螺旋CT/MRI影像特点分析

杨朝武; 何光武; 李征宇; 赵炳辉

中国临床医学影像杂志 ›› 2015, Vol. 26 ›› Issue (1) : 23-26.

论著

原发性胃肠道淋巴瘤64排螺旋CT/MRI影像特点分析

杨朝武1，何光武2，李征宇2，赵炳辉3

作者信息 +

Analysis of CT and MRI features of primary gastrointestinal lymphoma

YANG Chao-wu1, HE Guang-wu2, LI Zheng-yu2, ZHAO Bing-hui3

Author information +

文章历史 +

摘要

目的：探讨原发胃肠道淋巴瘤64排螺旋CT及1.5T MRI成像特点，提高该病的确诊率及准确率，为临床诊断治疗提供依据。资料与方法：回顾性分析我院近6年经内镜活检或手术病理确诊的32例病例CT及MRI资料，总结对该病诊断效力较高的影像学征象。结果：CT检查提示胃淋巴瘤增厚胃壁密度较均匀，累及宽基底部，动脉期“黏膜白线征”出现率87.5%，静脉期“三轨征”出现率81.3%，MRI检查T1WI及T2WI显示胃黏膜及浆膜有独特优势。肠道淋巴瘤以长管样肠壁环形增厚为特征，累及肠段多较长，肠壁密度或信号均匀且轻中度强化。其中小肠“动脉瘤样扩张”常见；结肠肠壁扩张伴积气积液常见，肠梗阻少见；回盲部以肿块形成更多见，肿块中心常见气体影，病变多同时累及回肠或升结肠，常继发肠梗阻。原发胃肠道淋巴瘤区域淋巴结受累多见，绝大多数受累淋巴结位于相应引流区域，散在淋巴结累及少见。结论：CT/MRI可以清楚显示原发性胃肠道淋巴瘤的病变特点及其周围组织浸润情况，典型CT/MRI征象对定性诊断有较大价值。

Abstract

Objective: To investigate CT and MRI features of primary gastrointestinal lymphoma in order to increase the diagnostic rate and accuracy and further provide evidence for clinical treatment. Methods: CT and MRI data from 32 patients with gastrointestinal lymphoma in recent 6 years in our hospital were retrospectively analyzed. All definite diagnosis was from endoscopy or pathology. Results: CT revealed that the thickening gastric wall had homogeneous density and broad base. The percent of mucosa with white lines in arterial phase was 87.5% and 3 layers with mucosa, tumor and serosa in venous phase was 81.3%. MRI had unique advantage in displaying mucosa and serosa on T1WI and T2WI. The intestinal lymphoma was characteristic of multi-segmental wall thickening in an annular way with mild to moderate enhancement. Aneurysm-like intestinal dilatation was common. Colonic dilatation could be detected with effusion and gas but intestinal obstruction was rare. A mass was usually formed with gas inside and secondary intestinal obstruction often happened when ileocecus, especially the ileum or ascending colon was involved. Regional lymph nodes were often involved in primary gastrointestinal lymphoma, commonly in the corresponding drainage area. Conclusion: CT and MRI could reveal the pathological feature and infiltration of surrounding tissue for primary gastrointestinal lymphoma clearly. Typical CT and MRI signs have great value in qualitative diagnosis.

导出引用

杨朝武;何光武;李征宇;赵炳辉. 原发性胃肠道淋巴瘤64排螺旋CT/MRI影像特点分析[J]. 中国临床医学影像杂志. 2015, 26(1): 23-26

YANG Chao-wu;HE Guang-wu;LI Zheng-yu;ZHAO Bing-hui. Analysis of CT and MRI features of primary gastrointestinal lymphoma[J]. Journal of China Clinic Medical Imaging. 2015, 26(1): 23-26

中图分类号： Ｒ735.2 R735.3 R733.1 R814.42 Ｒ445.2