小肠恶性淋巴瘤的影像学表现  

Imaging characteristics of malignant lymphoma of the small bowel

作　　者：陈留斌[1] 王毅[1] 李然[1] 石丹凤[1] 代波[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所放射科,重庆400042

出　　处：《中国现代医学杂志》2012年第20期91-95,共5页China Journal of Modern Medicine

摘　　要：目的分析小肠恶性淋巴瘤的影像特点,提高对该病的认识及术前诊断率。方法收集23例经手术和病理报告证实为小肠恶性淋巴瘤患者的胃肠道造影、CT及临床资料,回顾性分析其胃肠道造影和CT影像特征,并与手术和病理学结果进行对照。结果肿瘤发生于回肠19例,空肠1例,十二指肠1例,2例为空回肠同时受累。胃肠道造影表现为小肠局部瘤样扩张9例,肠管狭窄6例,腔内充盈缺损4例,其中3例可见龛影。CT检查12例,表现为肠壁增厚9例,其中2例伴肠腔扩大,腔内肿块3例,肠系膜浸润或淋巴结肿大3例,累及大网膜1例。胃肠道造影的定位诊断准确率为87.0%,但定性诊断的准确率仅为34.8%。CT的定位诊断准确率为100%,定性诊断准确率为75.0%。结论 CT能够对小肠恶性淋巴瘤提供更为全面准确的评价,常规胃肠道造影与CT检查相结合有助于制定更为恰当的治疗计划。[Objectives] To analyze the imaging features of malignant lymphoma of the small bowel, in order to facilitate its recognition and preoperative diagnosis. [Methods] Twenty-three patients with small bowel malignant lymphoma confirmed by operation and pathology were selected for this study. Their images of CT, conventional GI tract radiography and clinical data were analyzed retrospectively. The imaging findings were compared with surgical and histopathological results. [Results] According to the locations of the tumors, the ileum was involved in 19 cases, the jejunum and duodenum in 1 case respectively, and the ileum and je- junmn in 2 cases simultaneously. By GI tract radiographic studies, regional dilatation of small bowel was found in 9 cases, bowel canal stenosis in 6, intraluminal filling defect in 4 cases and three of them with niche. 12 cases were examined with CT, bowel wall thickening was showed in 9 cases and two of them with segmental bowel dilatation, intraluminal mass in 2 cases, mesenteric infiltration or lymphadenectasis in 3 cases and omentum involved in 1 case. The location and qualitative diagnostic accurate rate of conventional GI tract radiography were 87.0% and 34.8% respectively, however, that of CT were 100% and 75.0%. [Conclusion] CT is more overall and accurate than conventional GI tract radiography for diagnosing small bowel malignant lymphomas. Conventional GI tract radiography combined with CT is useful for the selection of the operative project and the therapy plan.

关 键 词：淋巴瘤 小肠 胃肠道造影 体层摄影术 X线计算机 

分 类 号：R735.32[医药卫生—肿瘤] R445[医药卫生—临床医学]