原发于纵隔（胸腺）淋巴瘤的MRI诊断  

MRI Diagnosis of Primary Mediastinal（Thymus） Lymphoma

作　　者：汪建华[1] 左长京[2] 田建明[1] 邵成伟[1] 郑建明[3] 金爱国[1] 吴国胜[1] 龚建国[1] 

机构地区：[1]第二军医大学附属长海医院医学影像科,上海200433 [2]第二军医大学附属长海医院核医学科,上海200433 [3]第二军医大学附属长海医院3病理科,上海200433

出　　处：《实用放射学杂志》2009年第2期187-191,199,共6页Journal of Practical Radiology

摘　　要：目的探讨MRI多序列合理应用和动态增强扫描对原发于纵隔（胸腺）淋巴瘤的诊断价值。方法对9例病理证实的原发于纵隔（胸腺）淋巴瘤的MRI表现进行了回顾性分析,并与胸腺瘤（癌）进行鉴别,归纳总结原发于纵隔（胸腺）淋巴瘤的MRI特征性表现。结果9例原发性胸腺淋巴瘤中2例为霍奇金淋巴瘤（HL）,5例为弥漫性大B细胞淋巴瘤,2例为前驱T细胞淋巴母细胞淋巴瘤/白血病。与胸腺上皮源性肿瘤比较：①淋巴瘤发病年龄明显较胸腺瘤、胸腺癌轻,为（29.7±17.0）岁。②肿瘤边缘模糊征象,淋巴瘤发生率与胸腺上皮源性肿瘤差异无统计学意义。③本组1例淋巴瘤可见假包膜,胸腺上皮源性肿瘤未见此征象;④分叶征,淋巴瘤发生率明显高于胸腺瘤,而与胸腺癌无明显差异。⑤延迟期＂边缘环形强化＂征象,淋巴瘤发生率高于胸腺瘤及胸腺癌。其他征象差异无明显统计学意义。结论MRI多种序列及动态增强扫描综合应用在对原发性胸腺淋巴瘤诊断方面具有一定价值。Abstract：Objective To investigate the value of MR multi--sequences imaging and dynamic enhancement in the diagnosis of primary mediastinal （thymus）lymphoma（PML）. Methods MRI features of 9 patients with PML confirmed by surgical pathology or biopsy were analyzed retrospectively. The imaging features of PML were compared with that of thymoma and thymic carcinoma. Resuits 9 cases of PML included 2 cases of hodgkin＇s lymphoma（HL） ,5 cases of DLBCL and 2 cases of T--LBL/ALL. The data of PML in comparison with that of thymoma and thymic carcinoma were as follow： ①The patients with PML were younger than those with thymoma and thymic carcinoma, averaged（29.7 ± 17.0） ages. ② There was no significant difference in obscure margins of tumor and incidence between thymoma and thymic carcinoma. ③One of PML was found having envelope, while no seen in thymus epithelioid neoplasia. ④The lobulated sign of tumors in PML was more common than that in thymoma, but no significant difference with thymic carcinoma. @At delayed phase of dynamic enhancement, the incidence of marginal circle enhancement in PML was higher than that of thymoma and thymic carcinoma. No statistically significant difference was found in other signs. Conclusion MR multi-- sequence imaging and dynamic enhancement is valuable in diagnosis of PML.

关 键 词：淋巴瘤 纵隔 胸腺 磁共振成像 

分 类 号：R734.5[医药卫生—肿瘤] R445.2[医药卫生—临床医学]