超声对Castleman病的诊断价值研究  

The Diagnostic Value of Ultrasound in Castleman′s Disease

作　　者：陈珂珂 陈芸[1] 吕衡 李浩[1] Chen Keke;Chen Yun;Lü Heng;Li Hao(Peking University Shenzhen Hospital,Clinical College of Anhui Medical University,Shenzhen,Guangdong 518036,China)

机构地区：[1]安徽医科大学北京大学深圳医院临床学院,北京大学深圳医院超声科,广东省深圳市518036

出　　处：《中国超声医学杂志》2020年第2期188-191,共4页Chinese Journal of Ultrasound in Medicine

基　　金：深圳市“三民工程”资助项目(No.SZSM201512026)。

摘　　要：目的总结Castleman病(CD)的超声表现及病理学特点,提高对该病的诊断准确率。方法回顾性分析12例经手术病理证实的CD超声声像图特点及病理表现。其中男4例,女8例,年龄19~61岁,平均40岁。结果超声均表现为椭圆形、边界清晰的不均质低回声肿块,其中局灶型10例,均为透明血管型,8例肿块内见细密点线样高回声,2例见散在斑点状粗大强回声;6例肿块内部为Ⅲ级血流信号,4例为Ⅱ级血流信号;7例肿块周边呈环形或半环形血流信号,3例血流信号稀少;6例肿块周围见粗大血管穿入。多中心型2例,1例为透明血管型,肿块内见向周边放射分布的条带状强回声,内部为Ⅱ级血流信号,周围呈半环形血流信号并有粗大血管穿入;1例为浆细胞型,肿块内可见细密点线样高回声,内部为Ⅲ级血流信号,周围血流信号稀少。结论超声显示边界清晰、内部回声不均的低回声肿块,内部血流信号丰富,周边有环形或半环形绕行血流信号,有粗大血管穿入时应考虑到CD可能,内部有强回声钙化者,高度提示透明血管型。Objective To summarize the ultrasonic manifestations and pathological features of Castleman′s disease(CD)and improve the diagnostic accuracy.Methods The characteristics of 12 cases of CD ultrasound confirmed by operation and pathology were analyzed retrospectively.Among them,there were 4 males and 8 females,aged 19-61 years,with an average age of 40 years.Results All the ultrasound findings were oval-shaped,well-defined heterogeneous hypoechoic masses,of which 10 were focal type and all were clear vascular type,8 were fine dotted line like hyperecho,and 2 were scattered spotted thick and strong echo.There were gradeⅢblood flow signals in 6 cases and gradeⅡblood flow signals in 4 cases.In 7 cases,there were annular or semi-annular blood flow signals around the mass,and in 3 cases,there were few blood flow signals.Large blood vessels were seen around the mass in 6 cases.There were 2 patients with polycentric type and 1 patient with clear vascular type.Within the mass,there were bands of strong echo radiating to the periphery.The interior was gradeⅡblood flow signal.One case was plasma cell type,with dense dotted line like hyperecho in the mass,gradeⅢblood flow signal inside,and sparse peripheral blood flow signal.Conclusions Ultrasound showed hypoechoic mass with clear boundary and uneven internal echo,rich internal blood flow signal,circumferential annular or semicircular circumferential blood flow signal,the possibility of CD should be considered when there are thick blood vessels penetrating,and the internal calcification with strong echo is highly suggestive of transparent vascular type.

关 键 词：CASTLEMAN病 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R551.2[医药卫生—诊断学]