多层螺旋CT和MRI对Castleman病的诊断价值  

Value of multi-slice spiral CT and MRI in diagnosis of Castleman disease

作　　者：干艳英 李大成[1] 陈雯[1] 

机构地区：[1]四川省简阳市人民医院放射科,四川简阳641400

出　　处：《西南国防医药》2012年第12期1321-1324,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨多层螺旋CT(MSCT)和MRI对Castleman病(CD)的诊断价值。方法对8例经病理证实为CD的MSCT和MRI表现进行回顾性分析。结果病变部位:胸部3例,颈部2例,腹膜后1例,腹膜后及盆腔同时发生1例,颈部、胸部及腋窝同时发生1例。临床分型:局灶型4例,其中1例周围见卫星灶;多中心型4例。病理类型:透明血管型7例,浆细胞型1例。MSCT或MRI表现:透明血管型CT平扫4例伴有点状、短条状及分支状钙化,其余为等密度,1例周围可见筋膜增厚,增强扫描均呈明显持续性强化,强化方式与大血管相似,1例中间可见条状低密度影;MRI检查1例,T1WI呈等信号,T2WI呈稍高信号,其内见条状低信号影,周围见条状血管影,增强扫描强化特点与CT相似。浆细胞型CT平扫表现为密度均匀,增强扫描呈轻度～中度强化。结论 CD的MSCT、MRI表现与临床类型、病理分型密切相关。MSCT和MRI对透明血管型CD的诊断具有较高的准确性,在本病的诊断中具有重要的价值;而浆细胞型缺乏特征性,确诊需要结合病理学。Objective To discuss the value of multi-slice spiral CT（MSCT） and MRI scanning in the diagnosis of Castleman disease（CD）.Methods A retrospective analysis was made in the MSCT and MRI manifestations of 8 patients who were pathologically diagnosed as CD.Results Locations of lesions were as follows： chest in 3 case,cervical part in 2 cases,retroperitoneal part in 1 case,lesions in both retroperitoneal and pelvic parts in 1 case,and in cervical part,chest,and armpit in 1 case.The clinical classifications included localized focuses in 4 cases in which satellite focuses were observed in one and multicentric type in 4 ones.The pathological types included hyaline-vascular type in 7 cases and plasma cell type in one case.The MSCT or MRI manifestations included hyaline-vascular type CT plain scanning in 4 cases with punctiform,dash form,and arborizing calcification,homogeneous attenuation on CT plain scans in the other ones.Moreover,fascial thickening could be observed around the mass in 1 case,and the enhancement scanning showed obvious continuous strengthening,the way of which was similar to that of the great vessel;in another one,stripe hypodense was observed.The MRI examination showed medium signal intensity of T1WI and high signal intensity of T2WI in one case,in which stripe low signal intensity and stripe blood shadow around the mass could be observed,and the features of the enhancement scanning was similar to that of CT.Plasma cell CT plain scanning showed homogeneous attenuation,and the enhancement showed mild-medium strengthening.Conclusion MSCT and MRI manifestations of CD are closely correlated with the clinical and pathological types.MSCT and MRI have a higher accuracy and great value in the diagnosis of hyaline-vascular type CD.The plasma cell type lacks characteristics,so its final diagnosis must be combined with pathologic examination.

关 键 词：CASTLEMAN病 CT 磁共振成像 诊断 

分 类 号：R557.4[医药卫生—血液循环系统疾病]