腹膜后局灶性Castleman病的CT和磁共振成像表现及病理特点  

CT and MRI features and pathological characteristics of retroperitoneal localized Castleman＇s disease

作　　者：王春[1] 周建军[2] 马周鹏[1] 章顺壮[1] 毛旭道[1] 邱鹏根[1] 滕华英[1] 

机构地区：[1]温州医学院附属慈溪医院放射科,宁波315300 [2]上海复旦大学附属中山医院放射科

出　　处：《中华肿瘤杂志》2014年第3期193-197,共5页Chinese Journal of Oncology

摘　　要：目的分析腹膜后局灶性Castleman病（LCD）的CT和磁共振成像（MRI）表现及其相关病理特征，探讨CT和MRI对LCD的诊断价值。方法回顾性分析13例经病理证实的腹膜后LCD患者的临床和影像学资料，13例患者均行CT检查，4例患者另行MRI检查。结果13例腹膜后LCD中，透明血管型12例，混合型l例。病灶均为单发，多位于肾脏周围；病灶最大直径4．2～8．6cm，平均5．9cm；病灶轮廓较清晰，以肾形多见。CT平扫示，10例呈略低密度，3例等密度。MRI平扫T1WI序列上4例呈等信号；T2WI序列上3例呈稍高信号，1例呈中等高信号。CT和MRI动态增强扫描表现相仿。CT动态增强扫描动脉期示，10例呈中等程度强化，2例显著强化，1例轻中度强化；5例强化较均匀，8例强化不均匀。CT动态增强扫描静脉期示，13例病灶均持续强化，8例动脉期不均匀强化的病灶，在静脉期强化范围扩大，其中2例病灶内部强化趋于均匀，6例见无强化低密度区；9例病灶周边可见单发或多发点状、斑条状卫星灶。结论CT和MRI动态增强扫描结合MRIT2WI脂肪抑制序列对腹膜后LCD的诊断具有重要价值。Objective To analyze the CT and MRI findings and pathological characteristics of retroperitoneal localized Castleman＇s disease and discuss the diagnostic and differential value of CT and MRI. Methods CT, MRI and clinical data of retroperitoneal localized Castleman＇s disease, proved by surgery and pathology, of 13 patients were reviewed. Among them, all the 13 cases received CT, and 4 cases received MRI examination. Results Among the 13 cases, 12 cases were of hyaline vascular type, and one was of mixed type. All foci were single mass and most foci located in the periphery of the kidney. The maximum diameter was 4.2 cm to 8.6 cm and the mean diameter of all tumors was 5.9 cm. The outline of most tumors was clear and kidney-shaped. On unenhanced CT, 10 cases showed low density and 3 cases showed isodensity. On plain MRI, four cases showed iso-signal on TIWI, three cases showed slightly high signal on T2WI and one showed moderately high signal. The CT and MRI findings were similar on contrast enhanced scan. In arterial phase, 10 cases showed moderate enhancement, 2 cases showed significant enhancement and one case showed moderate enhancement. Five cases showed rather homogeneous enhancement and 8 cases showed heterogeneous enhancement. In venous phase, all the 13 tumors showed continuous enhancement. Eight cases showing heterogeneous enhancement in arterial phase showed expanded range, and among them two cases showed tending to be homogeneous enhancement. Six cases showed areas of low density without enhancement, and 9 cases were accompanied with single or multi-satellite punctuate or striped foci around the tumors. Conclusion Dynamic contrast-enhanced CT and MRI combined with MR T2WI fat-suppression are of great importance in the diagnosis and identification of retroperitoneal localized Castleman＇s disease. [ Subject words] Giant lymph node hyperplasia; Retroperitoneal; Tomography, X-ray computed; Magnetic resonance imaging

关 键 词：巨淋巴结增生 腹膜后 体层摄影术 X线计算机 核磁共振成像 

分 类 号：R656.5[医药卫生—外科学]