25例胃淋巴瘤的CT征象分析  

CT Features of 25 Cases with Gastric Lymphomas

作　　者：吕衍春[1] 范卫君[1] 刘立志[1] 沈静娴[1] 李娴[1] 张玉晶[2] 

机构地区：[1]华南肿瘤学国家重点实验室 中山大学附属肿瘤防治中心医学影像与介入中心,广东广州510060 [2]华南肿瘤学国家重点实验室 中山大学附属肿瘤防治中心放疗科,广东广州510060

出　　处：《中山大学学报（医学科学版）》2008年第1期103-107,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省医学科研基金(303041096001)

摘　　要：【目的】总结胃淋巴瘤的CT表现特征,以提高CT对胃淋巴瘤的诊断价值。【方法】回顾性分析经病理证实的25例胃淋巴瘤的CT表现,包括胃受累的部位、病灶大体形态、侵犯范围、胃壁厚度、浆膜及胃周脂肪间隙受累情况、强化方式、坏死、其他器官受累、淋巴结肿大情况,并将CT征象与病理类型进行对照分析。【结果】本组25例胃淋巴瘤病人,均为非霍奇金氏淋巴瘤。大多数发生在胃窦(18/25,72%)和胃体(19/25,76%)。胃壁不均匀增厚,最厚处胃壁厚度为7mm～60mm,平均(21.3±12.9)mm,累及范围均大于胃全周的75%。22例(88%)患者病变呈中度均匀强化(与周围肌肉强化程度相近)。21例(84%)有腹腔淋巴结肿大,13例(52%)有肾门下腹膜后淋巴结肿大。绝大多数(19/25,76%)病例合并脾肿大。坏死及溃疡少见,分别只有1例(4%)。3例(3/25,12%)见胃周围侵犯。胃黏膜相关边缘带B细胞淋巴瘤与其他类型淋巴瘤比较,其CT征象具有一定特点,表现为较少累及胃窦,胃壁增厚程度较轻,上述差别均有统计学意义。【结论】胃淋巴瘤的CT表现具有一定特征性,而且,胃黏膜相关性边缘带B细胞淋巴瘤的CT征象有与其他类型胃淋巴瘤不同的特点,CT对于胃淋巴瘤的诊断和鉴别诊断有一定的帮助。[Objectives ] To summarize the CT features of gastric lymphomas for evaluating the diagnosis value of CT on gastric lymphoma. [Methods] CT imagings of 25 cases with gastric lymphomas proved by pathology were reviewed retrospectively. CT findings were observed as following, location, contour, extent, thickness of gastric wall, ectoptygma and fat space, mode of enhancement, involvement of the other organs, and enlargement of lymph nodes. The CT findings correlated to the pathologic types were analyzed respectively. [Results] All the 25 cases were non-Hodgin＇s lymphomas （NHL）. Most of them located in antrum （18/25,72%） and body of stomach （19/25,76%）. The gastric wall thickened to （21.3 ± 12.9） mm inhomogeneously, ranged from 7 mm to 60 mm. The lesions extended over 75% of gastric perimeter in all cases. The lesions in 22 of 25 cases （88%） were enhanced moderately and homogeneously. Twenty-one of 25 cases （84%） had abdominal lymph adenopathy. Thirteen of 25 cases （52%） had lymph adenopathy beneath renal hilum. Most cases （76%, 19/25） had splenomegaly. Necrosis was found in only one case. Ulcer was found in only one case. Involvement to the adjacent organs were founded in 3 （3/25, 12%） cases. Compared with other types of gastric lymphoma, There were some differences in CT features of mucosa associated lymphoid tissue lymphoma （MALT）, such as, rarely localized in antrum, the gastric wall,measured at the thickest point, was less than that of other types. [Conclusion] Some features in CT findings of gastric lymphomas were typical. There were some different CT features between MALT and other types of gastric lymphomas. CT was helpful in diagnosis and differential diagnosis of gastric lymphomas.

关 键 词：胃 淋巴瘤 体层摄影术 X线计算机 

分 类 号：R445.3[医药卫生—影像医学与核医学]