弥漫性淋巴管瘤病的多层螺旋CT淋巴管成像表现  

Multi-slice spiral CT lymphangiography features of diffuse lymphangiomatosis

作　　者：孙小丽[1] 沈文彬[2] 王仁贵[1] 陈孝柏[1] 温廷国[1] 赵君[1] 段永利[1] 傅岩[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院放射科,100038 [2]首都医科大学附属北京世纪坛医院淋巴外科,100038

出　　处：《中华放射学杂志》2014年第7期582-585,共4页Chinese Journal of Radiology

基　　金：首都临床特色应用研究资助项目（Z131107002213184）

摘　　要：目的 探讨弥漫性淋巴管瘤病的MSCT淋巴管成像表现.方法 回顾性分析32例经病理证实临床诊断为弥漫性淋巴管瘤病患者的影像资料,患者均于直接淋巴管造影术后行胸腹部MSCT联合平扫,其中13例行MSCT增强检查.分析病变累及的部位,并采用分类变量资料中的构成比进行统计描述.结果 32例患者的MSCT淋巴管成像均显示不同程度的淋巴管异常：胸导管梗阻15例（46.9％）,右淋巴导管梗阻3例（9.4％）,单（双）侧颈干反流5例（15.6％）,单（双）侧支气管纵隔干反流4例（12.5％）,造影侧腰干、髂淋巴管扩张32例（100.0％）,反流至对侧腰干、髂淋巴管28例（87.5％）,反流至双侧肾盂、肾窦2例（6.2％）,对比剂漏入单（双）侧胸腔9例（28.1％）、腹腔6例（18.8％）、肠腔2例（6.2％）,对比剂沉积在骨内8例（25.0％）、纵隔5例（15.6％）、心包3例（9.4％）、肌间隙3例（9.4％）,病理性骨折5例（15.6％）.常规MSCT表现为多个部位、多发、大小不等的囊性病变.结论 MSCT淋巴管成像能够显示弥漫性淋巴管瘤病的一些特征性表现,为诊断和鉴别诊断本病提供重要依据.Objective To investigate MSCT lymphangiography features of diffuse lymphangiomatosis.Methods MSCT images of 32 patients with diffuse lymphangiomatosis confirmed with clinical comprehensive diagnosis,surgery and pathology were retrospectively reviewed.Thoracic and abdominal MSCT examinations were performed after direct lymphangiography in all patients.Among them,13 patients underwent enhanced MSCT examination.The site and extent of the lesions were recorded,and the ratio of descriptive statistics was used according to categorical variable data.Results MSCT lymphangiography showed various degree of abnormal lymphatic vessels in all 32 patients：Obstructed thoracic duct was seen in 15 cases（46.9％）,obstructed right lymphatic vessel in 3 cases（9.4％）,unilateral （bilateral） cervical lymphatic stem reflux in 5 cases（15.6％）,unilateral（bilateral） bronchial-mediastinal lymphatic stem reflux in 4 cases（12.5％）.Lumbar trunk and iliac lymphatic vessel were dilated on the lymphangiography side in 32 cases（100.0％）,while 28 cases（87.5％） reflux to contralateral lumbar trunk and iliac lymphatic vessel,reflux to bilateral renal sinus in 2 cases（6.2％）,the contrast materials leak into unilateral（bilateral） thoracic cavity in 9 cases（28.1％）,abdominal cavity in 6 cases（18.8％） and intestinal cavity in 2 cases（6.2％）.The contrast materials were found in bone in 8 cases（25.0％）,mediastinum in 5 cases （15.6％）,pericardium in 3 cases（9.4％）,spatium intermusculare in 3 cases（9.4％）,pathological fractures were found in 5 cases（15.6％）.Conventional MSCT images showed different locations,multiple and various sizes cystic lesions.Conclusion MSCT lymphangiography can display the features of diffuse lymphangiomatosis.Thus,it provides an important basis for diagnosis and differential diagnosis of diffuse lymphangiomatosis.

关 键 词：淋巴管瘤 淋巴管造影术 体层摄影术 X线计算机 

分 类 号：R733.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]