腹部巨淋巴结增生症的CT及MRI表现  

CT and MRI Findings of Abdominal Castleman Disease

作　　者：杨泽锋 钟建平 张盛箭[2] 周良平[2] 彭卫军[2] YANG Ze-feng;ZHONG Jian-ping;ZHANG Sheng-jian;ZHOU Liang-ping;PENG Wei-jun(Department of Radiology, Zhuji People's Hospital;Department of Radiology, Cancer Hospital, Fudan University)

机构地区：[1]诸暨市人民医院放射科 [2]复旦大学附属肿瘤医院影像诊断科

出　　处：《中国医学计算机成像杂志》2018年第6期490-494,共5页Chinese Computed Medical Imaging

摘　　要：目的:分析腹部Castleman病(CD)的CT及MR影像学特征,以期提高对本病的影像学认识。方法:对10例经手术病理证实为腹部CD患者的CT及MRI表现进行回顾性分析。结果:本组病例有透明血管型(9例)和浆细胞型(1例);所有肿块边界清楚,形态规则,以椭圆形和或豌豆形居多。局灶肿块型9例,CT平扫均为等密度,3例肿块内可见钙化;动态增强扫描动脉期肿块明显强化,实质期5例病灶进一步持续性强化;4例强化稍退出;3例肿块周围可见扩张扭曲血管影。多发结节型1例,CT平扫呈均匀等密度,增强扫描动脉期轻中度强化,实质期进一步强化。本组4例行MRI扫描,平扫T1WI上低信号影,T2WI上为等或稍高信号影;动态增强扫描局灶肿块型病灶(3例)均明显且持续强化,肿块周围均可见完整包膜;多发结节型病灶(1例)呈轻中度强化。结论:CT及MRI动态增强多期扫描对腹部CD具有重要诊断价值。Purpose: To evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of abdominal Castleman disease (CD), in order to improve the imaging understanding of the disease. Methods: The CT and MRI manifestations of 10 patients with abdominal Castleman disease confirmed by surgical pathology results were retrospectively analyzed. Results: The patients were with hyaline-vascular type (9 cases) and plasma-cell type (1 case); All the masses showed well-defined margins and regular shapes, most of which were ovoid or pea shapes. Nine cases of unicentric CD showed iso-density on plain CT, and calcification was seen in 3 cases. On dynamic CT examination, all 9 masses displayed obvious homogeneous enhancement during arterial phase, with further continuous enhancement in 5 cases and slightly washed out in 4 cases during parenchymal phase. Dilated and distorted vessels were shown in 3 cases. One case of multicentric CD in our group showed iso-density on plain CT, mild to moderate enhancement during arterial phase and further enhancement during parenchymal phase. In MRI scanning, all 4 cases showed hypointense on T1WI and isointense or slightly hyperintense on T2WI. Obvious and continuous enhancement and the complete capsular were seen in 3 cases of unicentric CD during dynamic contrast scanning. One case of multicentric CD displayed mild to moderate enhancement. Conclusion: CT and MRI dynamic enhanced multiphase scans have important diagnostic value for abdominal CD.

关 键 词：巨淋巴结增生 腹部 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R445.3[医药卫生—诊断学]