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原发性肠道淋巴瘤的螺旋CT表型和征象分析

于铭 胡佳圆 宋焱 李飒英

于铭, 胡佳圆, 宋焱, 等. 原发性肠道淋巴瘤的螺旋CT表型和征象分析[J]. CT理论与应用研究, 2022, 31(4): 449-458. DOI: 10.15953/j.ctta.2022.090
引用本文: 于铭, 胡佳圆, 宋焱, 等. 原发性肠道淋巴瘤的螺旋CT表型和征象分析[J]. CT理论与应用研究, 2022, 31(4): 449-458. DOI: 10.15953/j.ctta.2022.090
YU M, HU J Y, SONG Y, et al. Analysis of spiral CT phenotypes and features of primary intestinal lymphoma[J]. CT Theory and Applications, 2022, 31(4): 449-458. DOI: 10.15953/j.ctta.2022.090. (in Chinese)
Citation: YU M, HU J Y, SONG Y, et al. Analysis of spiral CT phenotypes and features of primary intestinal lymphoma[J]. CT Theory and Applications, 2022, 31(4): 449-458. DOI: 10.15953/j.ctta.2022.090. (in Chinese)

原发性肠道淋巴瘤的螺旋CT表型和征象分析

doi: 10.15953/j.ctta.2022.090
详细信息
    作者简介:

    于铭:男,北京协和医学院在职硕士研究生,北京医院放射科住培生,主要从事医学影像诊断工作,E-mail:yuming1989@126.com

    宋焱:女,北京医院放射科主任医师、硕士研究生导师,主要从事医学影像诊断工作,E-mail:firesong@sina.com

    李飒英:女,北京医院放射科主任医师,主要从事医学影像诊断工作,E-mail:lisaying2000@163.com

    通讯作者:

    宋焱∗,女,北京医院放射科主任医师、硕士研究生导师,主要从事医学影像诊断工作,E-mail:firesong@sina.com

    李飒英∗,女,北京医院放射科主任医师,主要从事医学影像诊断工作,E-mail:lisaying2000@163.com

  • 中图分类号: R  816;R  322.2+7

Analysis of Spiral CT Phenotypes and Features of Primary Intestinal Lymphoma

  • 摘要: 目的:探讨原发性肠道淋巴瘤(PIL)的CT表现,以提高该病的影像诊断和鉴别水平。方法:收集北京医院从2013年3月至2022年2月的21例经病理证实的PIL患者资料,分析其CT表型及特征表现。结果:21例PIL均为非霍奇金淋巴瘤(NHL);12例为弥漫大B细胞淋巴瘤(DLBCL),3例为滤泡性淋巴瘤,2例为NK/T细胞淋巴瘤,2例为T细胞性淋巴瘤,黏膜相关淋巴组织淋巴瘤(MALT)和套细胞淋巴瘤(MCL)各1例;病变位于结肠7例,回肠5例,小肠系膜4例,回盲部2例,空肠1例,直肠1例,1例累及右半结肠和回盲部。CT检查显示,肠壁环周浸润型3例,肠壁增厚型3例,肿块型4例,动脉瘤样扩张型7例,肠系膜多发结节型4例。CT增强多表现为均匀的轻中度强化;21例患者中,2例合并肠穿孔,2例合并肠梗阻。结论:PIL的特征CT表现包括肠管多节段受累、肠壁局限性或弥漫性明显增厚、肠腔动脉瘤样扩张、偏心性密度均匀的肠腔肿块以及肠系膜“夹心面包征”,认识这些征象有助于提高对原发性肠道淋巴瘤的诊断。

     

  • 图  1  肠壁浸润型原发性肠道淋巴瘤

    (a)升结肠病灶,可见环周弥漫性肠壁浸润,病灶密度欠均匀,结肠周围脂肪间隙内线条状软组织密度影是病变延伸到浆膜和结肠周围脂肪的指征(白色箭头)。(b)对比增强动脉期横断面显示环周弥漫性肠壁增厚,不均匀中等强化。

    Figure  1.  Intestinal wall infiltrating form of primary intestinal lymphoma

    图  2  肠壁增厚型原发性肠道淋巴瘤

    CT平扫冠状面图像显示阑尾全段管壁增厚,阑尾肿大,内软组织密度影填充(白色圆圈),黏膜线清晰(白色箭头)。

    Figure  2.  Intestinal wall thickening form of primary intestinal lymphoma

    图  3  腔肿块型原发性肠道淋巴瘤

    3D slicer软件(哈佛大学&麻省理工学院)绘图(a)和CT增强动脉期图像(b)示病变可见肠系膜上动脉供血(白色三角形),肿块内“血管穿行征”(白色箭头)。

    Figure  3.  Luminal mass form of primary intestinal lymphoma

    图  4  动脉瘤样扩张型原发性肠道淋巴瘤

    CT平扫矢状面图像显示左下腹回肠壁局限增厚,呈“动脉瘤样扩张”(白色箭头)。

    Figure  4.  Aaneurysmal dilatation form of primary intestinal lymphoma

    图  5  肠系膜型原发性肠道淋巴瘤

    CT增强动脉期图像显示肠系膜区多发结节及肿块,融合成团,病灶密度均匀,包绕肠系膜血管(白色三角形)及脂肪,形成“三明治征”(白色箭头)。

    Figure  5.  Mesenteric form of primary intestinal lymphoma

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出版历程
  • 收稿日期:  2022-05-19
  • 修回日期:  2022-07-01
  • 录用日期:  2022-07-04
  • 网络出版日期:  2022-07-08
  • 刊出日期:  2022-08-01

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