Castleman病的影像学诊断与鉴别诊断  

Imaging Diagnosis And Differential Diagnosis Of Castleman'S Disease

作　　者：杨亮 桑节峰 Yang Liang Sang Jiefeng(Ganyu Lianyungang District traditional Chinese medicine hospital, 222002 People＇ s Hospital of Ganyu District, Lianyungang, 222002)

机构地区：[1]连云港市赣榆区中医医院影像科 [2]连云港市赣榆区人民医院影像科,222002

出　　处：《现代医用影像学》2016年第6期1018-1021,共4页Modern Medical Imageology

摘　　要：目的:回顾分析经本院经临床病理证实的Castleman病例,分析其临床及影像学特征以提高其临床诊断的准确率。材料与方法:搜集2010年1月至2015年12月间我院经手术病理证实的4例巨大淋巴结增生(CD)病例,所有病例均经多排螺旋CT平扫并增强扫描检查,部分病例行MRI检查。所有病例的CT图像均将其原始薄层图像输入ADW图像后处理工作站,进行MPR、VR、CPR、CTA等图像后处理进行观察,分析其临床及影像学特征。结果:4例患者CT平扫多为孤立单发软组织结节或肿块,伴或不伴卫星结节。其中单发3例,多发1例,病灶边缘光滑,界限清晰,密度多较均匀,部分病灶可见小片或星芒状低密度区,有的病灶可见点状钙化,为肿瘤中心放射或蔟状钙化。1例多发患者主要为多组淋巴结肿大,密度多较均匀,有肝脾轻度肿大,和少量腹水等表现。CT增强扫描所见:所有病例动脉期病灶明显强化,门脉期及延迟扫描肿块实质部分明显强化,肿块较大的病灶中心可见星芒状或裂隙状低密度灶。结论:Castleman病影像学上典型的表现为沿淋巴链分布的单发或多发的肿块,边界清晰,病灶中心的钙化和病灶中心的星芒状低密度是诊断CD的重要特征。在淋巴链分布区的富血供病变,在CT及MRI增强扫描动脉期表现明显强化,延迟期持续强化,并有中心瘢痕和钙化特点的病变,应考虑到Castleman病的可能性。Purpose ： To analyze the clinical and imaging features of Castleman＇ s disease patients confirmed by clinical pathology in order to improve the accuracy of clinical diagnosis. Materials and Methods： From December 2015 to January 2010, 4 cases of giant lymph node hyperplasia （CD） were confirmed by operation and pathology in our hospital. All cases were examined by CT plain scan and enhanced scan, some of the patients were examined by MRI. All cases of CT images were the original thin layer image input ADW image post-processing workstation, MPR, VR, CPR, CTA and other image processing for observation, analysis of its clinical and imaging features. Results ： CT plain scan in 4 patients were mostly solitary solitary soft tissue nodules or masses, with or without satellite nodules. Which one in 3 cases, 1 cases with multiple lesions, edge smooth, clear boundaries, density is uniform, some lesions showed the small or stellate shaped low density area, some lesions visible calcification, as the center of tumor radiotherapy or tufted calcification. 1 cases of multiple patients into groups of lymph nodes, the density is uniform, and has mild swelling and a small amount of ascites, etc.. CT enhanced scan： all cases of arterial lesions were significantly enhanced, the portal vein phase and delayed scan mass was significantly enhanced, the larger lesions were visible in the center of the center of the star or slit like low density lesions. Conclusion： The typical manifestations of Castleman＇ s disease imaging are solitary or multiple lesions along the lymphatic chain, clear boundary, calcification of the center of the lesion and low density of the center of the lesion is an important feature of the diagnosis of CD. The rich blood supply in the area of the lymph chain distribution was significantly enhanced in the CT and MRI enhanced scan arte- rial phase, and the delay time was strengthened, and the lesions with central scar and calcification should be taken into consideration to the possibility of Castleman

关 键 词：巨大淋巴结增生 计算机成像 图像后处理技术 

分 类 号：R551.2[医药卫生—血液循环系统疾病]