肝移植后淋巴组织增生性疾病的影像学分析  

Imaging Analysis of Posttransplantation Lymphoproliferative Disorder after Liver Transplantation

作　　者：张晓东[1] 季倩[1] 沈文[1] 祁吉[1] 

机构地区：[1]天津医科大学临床学院天津市第一中心医院放射科,天津300100

出　　处：《实用放射学杂志》2011年第3期382-386,共5页Journal of Practical Radiology

摘　　要：目的 初步探讨肝移植后淋巴组织增生性疾病（posttransplantation lymphoproliferative disorder,PTLD）的影像学、临床特点,以及现代医学影像学技术在该疾病诊断中的作用.方法 回顾性分析5例经病理证实的肝移植后PTLD的CT、B超、MRI等影像学资料（以CT资料为主）及临床资料并随访.结果 5例中,4例为B细胞淋巴瘤,1例为T细胞淋巴瘤.CT表现为肝门部形态规则或不规则低密度区,增强可见轻中度强化.B超表现为肝门部低回声区.MRI表现为长T1稍长T2信号影,增强可见轻度强化.肝门部结构均不同程度受累（4例胆管受压,2例肝动脉狭窄或闭塞,4例门静脉受累）.结论 肝移植术后PTLD常累及肝脏,增强CT或MRI检查可作为首选的影像学检查.了解PTLD的影像学表现并选择合适的影像学检查可以协助PTLD的诊断.Objective To preliminarily discuss the imaging and the clinical characteristics of posttransplantation lymphoproliferarive disorder（PTLD） after liver transplantation, as well as the utility of modern imaging techniques in the diagnosis of the disease. Methods The imaging features（CT data mainly） ,the clinical data and the follow-up information in five cases with PTLD after liver transplantation pathologically confirmed were analysed retrospectively. Results In the five cases,there were four cases with B-cell lymphoma and one with T-cell lymphoma. CT showed the lesions were well or ill-defined low density in porta hepatis with slight or moderate enhancement after administration of contrast medium. Sonogram showed hypoechoic area in porta hepatis. MRI demonster- ated the lesions were hypointensity on T1 WI and mild hyperintensity on T2 WI with slight enhancement after intravenous contrast medium injection. The structures of porta hepatis were all involved by the lesions in five cases（ bile duct compressed in four cases, hepatic artery stenosis or occlusion in two cases, portal vein involved in four cases）. Conclusion Liver itself is frequently involved in PTLD after liver transplantation,and contrast-enhanced CT or MRI can be chosen as the preferred examination. The recognition of the lesion＇s imaging features and the using of suitable imaging techniques can help the diagnosis of PTLD.

关 键 词：肝脏 移植术后淋巴组织增生性疾病 肝移植 体层摄影术 X线计算机 EB病毒 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学] R575[医药卫生—基础医学]