超声在肠道淋巴瘤诊断中的应用价值和技巧  

Application Value and Tips of Ultrasonography in Diagnosis of Intestinal Lymphoma

作　　者：米加 苗立英[1] 赵博[1] 葛辉玉[1] MI Jia;MIAO Liying;ZHAO Bo;GE Huiyu(Department of Ultrasound,Peking University Third Hospital,Beijing 100191,China;Department of Special Examination,Shandong Provincial Third Hospital,Jinan Shandong 250031,China)

机构地区：[1]北京大学第三医院超声科,北京100191 [2]山东省立第三医院特检科,山东济南250031

出　　处：《中国医疗设备》2022年第3期67-70,共4页China Medical Devices

基　　金：国家重点研发计划(2018YFC0116000);国家自然科学基金面上项目(31971169)。

摘　　要：目的探讨超声在肠道淋巴瘤诊断中的应用价值和扫查技巧。方法回顾性分析2013年6月至2020年4月北京大学第三医院收治的18例经手术或内镜病理证实的肠道淋巴瘤的病理类型、病变部位和超声表现分型信息,并比较用超声和CT分别测量的病变处的肠壁厚度的差异。结果病理类型:18例均为非霍奇金淋巴瘤,其中弥漫性大B细胞淋巴瘤14例,套细胞淋巴瘤2例,单形性嗜上皮性肠道T细胞淋巴瘤1例,Burkitt淋巴瘤1例;原发15例,继发3例。病变部位:5例位于小肠,1例位于回盲部,11例位于结肠,1例位于直肠。超声表现分型:肠壁增厚型8例,肠道肿块型7例,囊性病变型1例,非特异型2例。可见肠套叠、穿孔、扩张等并发征象,多数合并腹腔或腹膜后淋巴结肿大。肠壁增厚型淋巴瘤超声测得的病变最厚处肠壁厚度均值(1.13±0.69)cm,小于CT测量均值(2.21±1.06)cm(P<0.05)。结论肠道淋巴瘤的超声表现具有一定特征,超声可以较准确地显示病变部位、累及范围及并发症情况,对于肠道淋巴瘤的诊断有重要价值。应用超声评估肠道淋巴瘤的病变时,需注意全面扫查并应用逐级加压手法。Objective To explore the value and tips of ultrasonography in the diagnosis of intestinal lymphoma.Methods The pathological types,lesion sites and ultrasonic manifestations of 18 cases of intestinal lymphoma confirmed by surgery or endoscopic pathology during June 2013 to April 2020 were retrospectively analyzed.The differences of thickness of the intestinal wall at the lesion site measured by ultrasound and CT were compared.Results All of the 18 cases were non-Hodgkin’s lymphoma in pathology,including diffuse large B-cell lymphoma(n=14),mantle cell lymphoma(n=2),monomorphic epithelial intestinal T-cell lymphoma(n=1)and Burkitt lymphoma(n=1).There were 15 primary cases and 3 secondary cases.The involved locations included the small intestine(n=5),ileocecal region(n=1),colon(n=11)and rectum(n=1).The ultrasonic types included intestinal wall thickening type(n=8),intestinal mass type(n=7),cystic lesion type(n=1)and non-specific signs type(n=2).Intussusception,perforation,dilatation and other concurrent were seen,most of the cases were accompanied with abdominal or retroperitoneal lymphadenopathy.The mean thickness of intestinal wall at the lesion site measured by ultrasound was(1.13±0.69)cm,which was less than that measured by CT(2.21±1.06)cm(P<0.05).Conclusion The ultrasonic manifestations of intestinal lymphoma have certain characteristics.The lesion location,extent and complications of intestinal lymphoma can be accurately described by ultrasonography,which plays an important role in the diagnosis of intestinal lymphoma.Comprehensive scanning and step-by-step compression technique is the key point in evaluating the lesions of intestinal lymphoma when using ultrasonography.

关 键 词：肠道淋巴瘤 为非霍奇金淋巴瘤 超声分型 肠壁厚度 

分 类 号：R735.3[医药卫生—肿瘤] R445.1[医药卫生—临床医学]