原发性小肠淋巴瘤的多层螺旋CT诊断  

The diagnosis of primary small intestinal lymphoma by multislice spiral computed tomography

作　　者：唐永华[1] 陈克敏[1] 钟捷[2] 吴志远[1] 朱晖[1] 缪飞[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,上海200025 [2]上海交通大学医学院附属瑞金医院消化内科,上海200025

出　　处：《诊断学理论与实践》2008年第1期42-46,共5页Journal of Diagnostics Concepts & Practice

基　　金：上海市卫生局课题(05-Ⅲ-005-026)

摘　　要：目的:探讨原发性小肠淋巴瘤(PSIL)的多层螺旋CT(MSCT)的影像学表现及其诊断价值。方法:回顾性分析32例经手术、病理确诊并符合Dawson标准的PSIL患者的MSCT资料。结果:32例PSIL病例中,单发生于回肠者23例,空肠6例,十二指肠1例,2例同时发生于空、回肠。根据PSIL患者的CT表现,可分为5型:浸润型(12例)、肠腔动脉瘤样扩张型(10例)、息肉肿块型(2例)、肠系膜型(3例)、混合型(5例)。MSCT表现为病变肠管的黏膜面多连续、较光整,肠壁不规则增厚,以黏膜下层和肌层增厚为主,肠管仍保持一定的扩张度和柔软度,病灶轻-中度强化,且各型PSIL病灶增强前后CT值差异均无统计学意义。20例PSIL患者行多层螺旋CT小肠造影检查,其对小肠淋巴瘤定位、定性与术后诊断的符合率分别为100%、95%。结论:PSIL的MSCT表现有相对特征性,MSCT小肠造影检查对PSIL术前诊断有较高价值。Objective To investigate the manifestation and diagnostic value of multislice spiral CT （MSCT） in primary small intestinal lymphoma （PSIL）. Methods The MSCT data of 32 operated cases of PSIL diagnosed pathologically and in accordance with Dawson criteria were retrospectively analyzed. Results Of these 32 patients with PSIL, 30 had solitary lesion （23 lesions located in the ileum, 6 in the jejunum, and 1 in the duodenum）, and 2 were found in both the ileum and the jejunum. PSIL patients could be categorized into 5 types according to CT manifestation： infiltration type （n=12）, luminal aneurismal dilatation type （n=10）, polypoid mass type （n=2）, mesentery type （n=3） and mixed type（n=5）. The MSCT manifestations were： mucosa of the involved bowel was continous, smooth and intact; irregular thickening of bowel wall mainly involved submucosa and muscular layer; involved bowel still kept some degree of distensibility and fragility. The lesion showed mild to moderate intensification. All five types of PSIL did not show significant difference in CT value before and after enhancement. MSCT enteroclysis was done in 20 cases, its diagnostic accuracy in localization and characterization was 100% and 95% respectively. Conclusions MSCT manifestation of PSIL was characteristic; MSCT enteroclysis was of high value for the diagnosis of PSIL before surgical operation.

关 键 词：小肠肿瘤 淋巴瘤 X线计算机断层扫描 

分 类 号：R735.32[医药卫生—肿瘤]