原发性和继发性小肠淋巴管扩张症直接淋巴管造影后CT对比分析  

CT Differentiation of Primary from Secondary Intestinal Lymphangiectasis with the Help of Direct Lymphangiography

作　　者：魏海亮[1] 张建梅[1] 宋建美[1] 张春燕[1] 陈孝柏[1] 

机构地区：[1]医科大学附属北京世纪坛医院放射中心,首都100038

出　　处：《临床放射学杂志》2014年第10期1545-1550,共6页Journal of Clinical Radiology

摘　　要：目的探讨直接淋巴管造影后CT对原发性和继发性小肠淋巴管扩张症的鉴别诊断价值。方法回顾性分析27例原发性小肠淋巴管扩张症和17例继发性小肠淋巴管扩张症患者的发病年龄、就诊年龄、病程、临床表现及直接淋巴管造影后CT扫描的影像学表现。并将原发性和继发性小肠淋巴管扩张症的上述各种表现通过SPSS 17.0软件进行统计学处理。结果 27例原发性和17例继发性小肠淋巴管扩张症患者的发病年龄和就诊年龄差异有统计学意义(P<0.001);二者的病程差异无统计学意义(P>0.05);二者在低蛋白血症等12项临床表现的比较差异无统计学意义(P>0.05);二者在直接淋巴管造影后CT扫描显示只有淋巴管发育不良一项表现差异均无统计学意义(P<0.001);其余包括肠道内和肠道外及淋巴管扩张、增生及淋巴异常返流等13项表现差异无统计学意义(P>0.05)。结论直接淋巴管造影后CT扫描可以显示小肠淋巴管扩张症的诸多异常表现,包括肠道内、肠道外及淋巴管扩张、增生及淋巴异常返流等,但上述异常表现在原发性和继发性小肠淋巴管扩张症中差异无统计学意义,而直接淋巴管造影后CT扫描显示淋巴管发育不良可作为原发性和继发性小肠淋巴管扩张症的鉴别依据,原发性小肠淋巴管扩张症多伴有淋巴管发育不良,而后者很少伴有淋巴管发育不良。另外,原发性和继发性小肠淋巴管扩张症的发病年龄和就诊年龄差异有统计学意义,前者年龄偏小,后者年龄偏大。Objective To evaluate CT scanning following direct lymphangiography in differentiating primary from secondary intestinal lymphangiectasis. Methods A total of 27 patients with primary intestinal lymphangiectasis（primary group） and 17 patients with secondary intestinal lymphangiectasis （secondary group） were enrolled in this study.The clinical data,including age,course of disease,clinical manifestations,etc.were analyzed.CT scanning which was performed after direct lymphangiography was carried out in all patients.CT findings were compared between the two groups.The results were statistically analyzed using SPSS 17.0 software.P 0.05 was defined as no significant difference,and P 0.05 was defined as significant difference.Results Significant difference in patient＇s age at the onset of the disease existed between the primary group and the secondary group（P 0.001）,while there was no significant difference in the course of the disease between the two groups（P 0.05）.No statistically significant differences in 12 clinical indexes,such as hypoalbuminemis,existed between the two groups（P 0.05）.CT scanning following direct lymphangiography indicated that there was significant difference in lymphatic dysplasia between the two groups（P 0.001）,while in all the other 13 indexes,including intra-intestinal and extra-intestinal lymphangiectasis,lymphatic hyperplasia,abnormal lymphatic reflux,etc.the differences were not statistically significant between the two groups（P 0.05）.Conclusion CT scanning performed after direct lymphangiography can clearly display many abnormal features of intestinal lymphangiectasis,including intra-intestinal and extra-intestinal lymphangiectasis,lymphatic hyperplasia,abnormal lymphatic reflux,etc.although the differences in above mentioned signs are not statistically significant between the primary intestinal lymphangiectasis and the secondary intestinal lymphangiectasis,nevertheless,the sign of lymphatic dysplasia on CT scans can be use to differentiate primary intestinal

关 键 词：小肠淋巴管扩张症 淋巴管 淋巴疾病 淋巴造影术 体层摄影术 X线计算机 

分 类 号：R574.5[医药卫生—消化系统]