胃黏膜相关淋巴组织淋巴瘤与弥漫性大B细胞淋巴瘤CT对比研究  

Comparison of CT features between gastric mucosa associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma

作　　者：林少帆[1] 林黛英[1] 吴先衡[1] 杨江爽 郑旭峰[1] 吴耀滨 LIN Shaofan;LIN Daiying;WU Xianheng;YANG Jiangshuang;ZHENG Xufeng;WU Yaobin(Department of Radiology,Shantou Central Hospital//Affiliated Shantou Hospital of Sun Yat-Sen University,Shantou 515041,China)

机构地区：[1]汕头市中心医院//中山大学附属汕头医院放射科,广东汕头515041

出　　处：《汕头大学医学院学报》2020年第1期16-19,共4页Journal of Shantou University Medical College

摘　　要：目的:探讨胃黏膜相关淋巴组织(MALT)淋巴瘤和弥漫性大B细胞淋巴瘤(DLBCL)的CT影像学特征,为两者的影像学鉴别诊断提供依据。方法:收集2013年1月至2019年9月汕头市中心医院20例胃淋巴瘤的CT检查资料,其中MALT淋巴瘤9例,DLBCL 11例。回顾性分析两种类型胃淋巴瘤CT影像学特征,包括病变部位及累及部位数、病变范围、胃壁厚度、黏膜面结节状突起等。结果:MALT淋巴瘤与DLBCL常累及胃窦和胃体,多表现为弥漫性和节段性胃壁增厚,增强扫描多见均匀轻度/中度强化,黏膜面可见皱襞肥大,呈结节状突起,病变较少侵犯浆膜面,常合并腹腔内淋巴结肿大。胃壁厚度于MALT淋巴瘤与DLBCL两组间比较有差别(t=?2.249,P=0.037),胃壁厚度区分MALT淋巴瘤与DLBCL的ROC曲线下面积为0.788(P=0.030),以16.5 mm为阈值鉴别MALT淋巴瘤与DLBCL的灵敏度和特异度分别为90.9%、66.7%,约登指数为0.576。黏膜面结节状突起两组间比较有差别(P=0.028)。结论:胃淋巴瘤的CT表现具有一定的特征性,胃壁厚度和黏膜面结节状突起是鉴别MALT淋巴瘤与DLBCL的有效指标。Objective:To explore the CT features of gastric mucosa associated lymphoid tissue(MALT)lymphoma and diffuse large B-cell lymphoma(DLBCL),and to provide the basis for their imaging differential diagnosis.Methods:From January 2013 to September 2019,CT data of 20 cases of gastric lymphoma in Shantou Central Hospital were collected,including 9 cases of MALT lymphoma and 11 cases of DLBCL.The CT features of two types of gastric lymphoma were analyzed retrospectively,including the location and number of involved parts,the scope of the lesion,the thickness of gastric wall,and the nodular process on the mucosal surface.Results:MALT lymphoma and DLBCL often involve gastric antrum and body,most of them show diffuse and segmental thickening of gastric wall,most of them show uniform mild/moderate enhancement on enhanced scan,and the mucosal surface shows fold hypertrophy,which presents nodular process,less lesions invade serous surface,and often associated with intraperitoneal lymphadenopathy.The difference of gastric wall thickness between MALT lymphoma and DLBCL was significant(t=?2.249,P=0.037).The area under the curve of MALT lymphoma and DLBCL was 0.788(P=0.030).The sensitivity and specificity of 16.5 mm threshold were 90.9%,66.7%and Youdern index was 0.576.The nodular process on the mucosal surface was different between the two groups(P=0.028).Conclusion:The CT features of gastric lymphoma have certain characteristics.The thickness of gastric wall and nodular process on mucosal surface are the effective indexes to distinguish MALT lymphoma from DLBCL.

关 键 词：胃黏膜相关淋巴组织淋巴瘤 弥漫性大B细胞淋巴瘤 体层摄影术 X线计算机 

分 类 号：R445.3[医药卫生—影像医学与核医学] R735.2[医药卫生—诊断学]