原发性肝脏淋巴瘤的影像学表现  

Imaging Findings of Primary Hepatic Lymphoma

作　　者：胡慧娟[1] 廖美焱[1] 田志雄[1] 彭碧荣[1] 

机构地区：[1]武汉大学中南医院CT室,430071

出　　处：《临床放射学杂志》2014年第8期1205-1208,共4页Journal of Clinical Radiology

摘　　要：目的探讨原发性肝脏淋巴瘤(PHL)的CT及MRI影像学表现,以提高对该病的诊断水平。方法回顾性分析16例PHL患者的CT及MRI影像学特点。结果 16例病理组织学检查均为非霍奇金淋巴瘤,免疫组织化学示10例为B细胞表型,6例为T细胞表型;8例呈单发肿块,6例为多发结节、肿块,2例为多发斑片状结节;12例病变边界较清晰,4例边界模糊。CT平扫均表现为低或稍低密度;增强扫描动脉期病灶强化不明显,呈轻-中度强化,较正常肝组织强化弱;门静脉期病灶强化稍加强,延迟期强化减弱;12例行MRI扫描,在T1WI上均表现为低信号,T2WI上均表现为高信号,其内信号较均匀;增强扫描呈轻-中度强化,4例呈周边环形强化,1例肿瘤中可见血管走行,类似"血管漂浮征"。结论肝脏原发淋巴瘤可单发或多发,边界大部分较清晰,CT平扫呈低密度,密度相对较均匀,增强呈轻-中度均匀强化或周边环形强化,部分病灶内可见类似"血管漂浮征"。CT及MRI能够清晰显示肿瘤的部位、数目、形态、内部结构及血供情况等,对肝脏淋巴瘤的诊断有较大价值。Objective To investigate the imaging features of primary hepatic lymphoma （PHL） so as to improve its diagnostic accuracy. Methods CT and MRI findings in sixteen patients with pathologically-proved PHL were retrospectively analyzed. Results Pathological examination showed that all the sixteen cases suffered from non-Hodgkin lymphoma （NHL）. Immunohistoehemical examination indicated that 10 patients had B-cell NHL and 6 patients had T-cell NHL. Among the sixteen cases, solitary liver mass was seen in eight, multiple nodules in six, and multiple speckled nodules in two. The lesion was well defined in 12 cases, and the lesion had a vague margin in 4 cases. On plain CT scanning, all lesions were characterized by low-density or slightly low-density areas without obvious enhancement in arterial phase, only mild or moderate degree of enhancement could be seen, the enhancement degree was weaker than that of the normal liver tissue. The lesiong enhancement was slightly increased in portal phase and decreased in delayed phase. MRI scanning was carried out in 12 cases, and the lesions were manifested as homogeneous hypo-intensity signal on T1WI and homogeneous hyper-intensity signal on T2WI. Dynamic Gd-DTPA enhanced MRI scanning demonstrated that the lesions showed slightmoderate enhancement, with peripheral ring-shaped enhancement in 4 cases. Blood vessels within the lesion were seen in one case, which was regarded as ＂blood vessel floating＂ sign. Conclusion The lesion of PHL can be single or multiple. Usually the tumor has a clear border and presents as homogeneous low-density mass on plain CT scans, and mild to moderate homogenous enhancement or peripheral ring-like enhancement on enhanced CT scans. The ＂blood vessel floating＂ sign can be observed in some lesions. Both CT and MRI scanning can clearly display the location, number, shape, internal structures and the blood supply of the tumor, which is very useful in making the diagnosis of hepatic lymphoma.

关 键 词：原发肝淋巴瘤 非霍奇金淋巴瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤]