纵隔恶性淋巴瘤的多层螺旋CT强化特征及其优势解剖分布  

Contrast-enhanced Multislice CT Features and Predominant Anatomic Distribution of Mediastinal Malignant Lymphoma

作　　者：李媛[1] 杨志刚[1] 郭应坤[1] 余建群[1] 卢春燕[1] 白红利[1] 朱培菊[1] 

机构地区：[1]四川大学华西医院放射科,成都610041

出　　处：《生物医学工程学杂志》2007年第5期1045-1049,共5页Journal of Biomedical Engineering

摘　　要：通过对31例经临床病理证实的纵隔恶性淋巴瘤患者(包括9例何杰金氏病和22例非何杰金淋巴瘤)进行多层螺旋CT平扫及增强扫描,探讨纵隔恶性淋巴瘤的多层螺旋CT强化特征及其优势解剖分布。在多层螺旋CT强化图像上观察所有病例增大淋巴结的大小、形态、密度以及强化特征,并结合美国胸科协会(ATS)纵隔淋巴结的解剖分区,明确其优势解剖分布。结果表明,31例患者中增大的淋巴结均呈圆形或类圆形,72.7%HD和88.9%NHL淋巴结增大呈普遍均匀强化密度,27.3%HD和11.1%NHL呈部分均匀强化合并坏死密度。HD常优势地累及2R(77.8%)、3(55.6%)、4R(88.9%)、4L(55.6%)、5(66.7%)、6(55.6%)、7(66.7%)及10R(55.6%)等区域;而NHL则常优势地累及2R(68.2%)、3(54.5%)、4R(59.1%)、4L(50%)、5(54.5%)、6(54.5%)、7(54.5%)及8(50%)等区域。同时心包(19.4%)、胸膜(19.4%)、大血管(6.4%)、肺(6.4%)、胸壁(3.2%)及乳腺(3.2%)等结外器官也受累。提示纵隔恶性淋巴瘤多层螺旋CT表现具有特征性,并存在优势解剖分布,可为临床诊断和分期提供影像学证据。The objective of this study was to investigate the specific contrast-enhanced MSCT features and predominant anatomic distribution of mediastinal malignant lymphoma. Contrast-enhanced MSCT in 31 cases of mediastinal malignant lymphomas were retrospectively evaluated by analyzing the features of size, morphology, attenuation and anatomic distribution in accordance to the ATS classification of intrathoracic lymph nodes. Nine cases of Hodgkin Disease （HD） and 22 cases of Non- Hodgkin Disease （NHL） were included. The enlarged nodes were found to be homogeneous （HD 72.7%, NHL 88.9%） and partly homogeneous with necrosis （HD 27.3%, NHL 11.1%）. HD involved predominantly the lymph nodes in the areas of 2R（77.8%）, 3（55.6%）, 4R（88.9%）, 4L （55.6%）, 5（66. 7%）, 6（55.6%）, 7（66. 7%） and 10R（55.6%）. while NHL often involved the areas of 2R （68.2%）, 3（54.5%）4R（59.1%）, 4L（50%）, 5（54.5%）, 6（54. 5%）, 7（54.5%） and 8（50%）. The following extranodal organs were involved：pericardium （19.4%）, pleura （19.4%）, great vessels （6. 4%）, lung （6.4%）, chest wall （3.2%） and breast （3.2%）. Mediastinal malignant lymphoma had some characteristic manifestations and predominant anatomic distribution shown on contrast-enhanced MSCT, which can provide imaging evidences for diagnosis and for determining the tumor stage.

关 键 词：纵隔 淋巴瘤 体层摄影术 X线计算机 解剖学 美国胸科协会 

分 类 号：R734.5[医药卫生—肿瘤]