多层螺旋CT三期增强扫描诊断胃原发性淋巴瘤的价值  

The Value of Tri-enhanced Phases Multi-slice Spiral CT in Diagnosis of Primary Gastric Lymphomas

作　　者：朱力平[1] 殷云娟[1] 

机构地区：[1]江苏省无锡市第三人民医院放射科,江苏无锡214041

出　　处：《中国医学影像学杂志》2011年第10期729-732,共4页Chinese Journal of Medical Imaging

摘　　要：目的探讨胃原发性非霍奇金淋巴瘤(NHL)多层螺旋CT(MSCT)三期增强扫描的表现及价值。资料与方法回顾性分析18例经手术和活检病理证实的经MSCT平扫和三期增强扫描的胃原发性NHL的CT资料,包括胃受累的部位、病灶大体形态、侵犯范围、生长方式、胃壁厚度、强化方式、胃壁的柔软性、胃周脏器侵犯、淋巴结肿大情况,所有病例均做多平面重组(MPR)。结果胃原发性NHL的CT表现可分为3种类型:胃壁弥漫增厚型9例,胃壁局限增厚型7例,肿块型2例。MSCT表现:平扫示胃壁局限或弥漫性增厚;增强扫描示16例动脉期病变轻度强化,门静脉期强化变明显,且强化较均匀,延迟期强化减低;2例病灶动脉期、门脉期均明显强化,延迟期强化程度减低;17例胃黏膜线呈细线样连续强化,1例呈不连续强化。在不同时相扫描,病变胃壁均有一定的柔软性;通过MPR重建,16例胃原发性NHL呈沿长轴生长特点。18例病例均未见幽门梗阻。结论胃原发性NHL在CT三期增强扫描的表现有一定的特征性,包括病灶的强化方式、黏膜线的连续性、胃壁具有一定的柔软性、病变沿胃长轴生长等特点,可弥补胃镜的不足,有助于准确诊断和术前评估。Purpose To discuss the MSCT tri-enhanced phases features of primary gastric non-Hodgkin＇s lymphomas（NHL） and to evaluate its clinical value.MMaatteerriiaall aanndd MMeetthhooddss CT features of 18 cases of primary gastric NHL confirmed by pathology were retrospectively analyzed,which included the location,the morphology,invasion range,growth patterns,enhancement patterns,the thickness and softness of the gastric wall,the invasion of perigastric fat and other organs,and lymph node enlargement,etc.We did multi-planar reconstruction（MPR） for all cases.Results The CT features of primary gastric NHL were divided into three types：the type of diffuse gastric wall thickening were found in 9 cases,the type of local gastric wall thickening in 7 cases,and the type of mass in 2 cases.The edge of lesions was clear and smooth on pre-contrast images.On enhanced images,16 cases were mild enhanced in the arterial phase,obvious and homogeneous enhanced in the portal phase,decreased enhancement in the delayed phase;2 cases with obvious enhancement in the arterial and portal phases,and with decreased enhancement in the delayed phase.17 cases were enhanced with hairline-like continuous gastric mucosa on the surface of the lesions.1 case showed discontinuous enhancement.The gastric wall in the lesion location was somewhat soft in different phases.MPR showed that the primary gastric NHL grew along the long axis.No pyloric obstruction was found in all cases.Conclusion The tri-enhanced phases CT features of primary gastric NHL had some characteristics,including gastric mucosa continuity,gastric wall softness,lesions enhancement patterns,and lesions growth along the long axis etc,which would aid to the accurate diagnosis and preoperative evaluation and help make up the disadvantage of gastroscopy.

关 键 词：淋巴瘤 胃肿瘤 体层摄影术 螺旋计算机 

分 类 号：R733.41[医药卫生—肿瘤] R735.204.54[医药卫生—临床医学]