肾脏继发性淋巴瘤的多层螺旋CT诊断  

Multi-Slice Spiral CT Diagnosis of Renal Secondary Lymphoma.

作　　者：郑文龙[1] 吴爱琴[2] 许崇永[2] 

机构地区：[1]浙江省温州市第二人民医院放射科,325000 [2]温州医学院附属第二医院放射科

出　　处：《医学研究杂志》2011年第6期131-133,共3页Journal of Medical Research

摘　　要：目的探讨肾脏继发性淋巴瘤(RSL)的多层螺旋CT诊断价值。方法搜集RSL共6例,左肾4例,右肾1例,两肾同时累及1例,回顾性分析其CT平扫和增强表现特点。结果 RSL巨块型2例、结节型1例、肾窦型2例、肾周肿块型2例。均表现为相应部位为主的软组织肿块,平扫病灶呈等或稍高密度,增强皮髓质期病灶轻度不均匀强化,实质期及排泄期强化趋于均匀;巨块型和肾周肿块型常表现为肾血管受包埋及牵拉,穿行其间,管腔受压狭窄,但无破坏及肾静脉瘤栓征象,形成"血管穿越征";排泄期肾盂及肾盏受压变窄、变形,远侧肾盏轻度扩张积水,但未侵入肾盂肾盏腔内,形成"肾盂挤压征"。巨块型和肾周肿块型RSL极易侵犯同侧肾上腺和累及对侧肾脏、肾上腺,常伴腹膜后间隙引流淋巴结肿大,并融合成巨大团块,腹主动脉、下腔静脉常包埋其中,呈"腹主动脉淹没征"。结论 RSL CT征象具有一定特征,对于准确诊断淋巴瘤及指导临床治疗具有重要意义。Objective To investigate the diagnostic value of multi - slice spiral CT in renal secondary lymphoma（ RSL）. Methods 6 cases of RSL including 4 cases in left kidney, 1 case in right kidney and 1 cases in both kidneys at the same time were collected in the study. The plain and enhanced CT signs of RSL were retrospectively analyzed. Results The signs of RSL demonstrated the huge mass type （2 cases）, the nodular type （1 case）, the renal sinus type （2 cases） and the perirenal mass type （2 cases）. It mainly demonstrated soft tumors of corresponding kidney zone. It appeared isodense or slightly higher density in CT plain scanning, mild heterogeneous en- hancement in corticomedullary phase, almost homogeneous enhancement in parenchymal and excretion phase. The involved renal vessels with narrow lumen were embedded and pulled in huge mass and peri - reral mass types. It had no damage and renal vein tumor thrombus, appeared ＂vascular passed through sign＂. In excretion phase, renal pelvis and renal calices were compressed, deformed and narrowed. It had mild distal hydrocalycosis. But it did not invade renal pelvis and renal calices, showed ＂pelvis extruded sign＂. Lesions of the ipsilat- eral adrenal gland, the contralateral kidney and adrenal gland were easily violated and involved in huge mass and perirenal mass type of RSL. RSL was often accompanied by retroperitoneal enlarged lymph nodes in draining space and integrated into the great mass. The ab- dominal aorta and inferior vena cava were often embedded by tumors, represented＂ abdominal aorta drown sign＂. Conclusion The signs of multi - slice spiral CT in RSL have certain special characteristics. It has great significance for lymphoma diagnosis and guiding clinical treatment.

关 键 词：肾脏 淋巴瘤 继发性 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]