多层螺旋CT鉴别腹盆腔霍奇金病和非霍奇金淋巴瘤的价值  

Value of Multislice Spiral CT in Differentiating Abdominal and Pelvic Hodgkin's Disease from Non-Hodgkin's Lymphoma

作　　者：杨浩[1] 刘建[1] 杨丹丹 赵正凯 高敏 Yang Hao;Liu Jian;Yang Dandan(Department of Radiology,The Third People's Hospital of Chengdu,Chengdu,Sichuan 610031,China)

机构地区：[1]成都市第三人民医院放射科,四川成都610031

出　　处：《四川医学》2023年第10期1077-1081,共5页Sichuan Medical Journal

基　　金：四川省医学会(恒瑞)科研基金专项科研课题(编号:2021HR53)。

摘　　要：目的明确多层螺旋CT鉴别腹盆腔霍奇金病(HD)和非霍奇金淋巴瘤(NHL)的价值。方法腹盆腔恶性淋巴瘤66例,其中HD 16例,NHL 50例。通过多层螺旋CT增强检查,观察腹盆腔淋巴结大小、形态、密度及解剖分布。结果恶性淋巴瘤CT增强,HD中13例为均匀密度,3例为部分坏死;NHL中39例为均匀密度,11例为部分坏死,两者强化类型差异无统计学意义(P>0.05)。HD和NHL均优势累及腹主动脉周围上下部、肠系膜根部、肝十二指肠韧带及肝胃韧带;盆腔淋巴结肿大多发生在髂总动脉,其次为髂内动脉;两者解剖分布差异无统计学意义(P>0.05)。HD和NHL多同时累及2个部位以上的淋巴结。恶性淋巴瘤亦累及肝、脾、肾、胃肠等淋巴结外器官,其中以脾受累最为常见。HD和NHL之间差异有统计学意义(P<0.05)。结论多层螺旋CT增强扫描可显示HD和NHL累及腹盆腔淋巴结的病理改变及优势解剖分布,有利于两者诊断、分期及治疗。Objective To clarify the contrast-enhanced multislice spiral(MSCT)differential diagnostic value between Hodgkin's disease(HD)and non-Hodgkin's lymphoma(NHL)involving abdominal and pelvic lymph nodes.Methods 66 cases of pathologically proved malignant lymphoma involving the abdominal lymph nodes were collected,of which HD was seen in 16 patients and NHL in 50.The observation of MSCT enhancement signs was focused on the size,shape,density and anatomic distribution of the abdominal and pelvic lymph nodes involved by malignant lymphoma.Results The enlarged lymph nodes showed homogeneous(HD 13,NHL 39)and inhomogeneous with necrosis(HD 3,NHL 11).There were no significant difference in enhancement pattern between HD and NHL(P>0.05).HD and NHL were mainly involved in the upper and lower parts around the abdominal aorta,mesenteric root,hepatoduodenal ligament and hepatogastric ligament.The common iliac artery was the most common,followed by the internal iliac artery.There was no significant difference in anatomical distribution between the two groups(P>0.05).HD and NHL usually involved more than two lymph nodes simultaneously.Malignant lymphoma also involved liver,spleen,kidney,gastrointestinal and other lymph node organs,of which the spleen was the most commonly involved.There was statistical difference between HD and NHL(P<0.05).Conclusion MSCT manifestations can represent the gross pathological features and anatomic distribution of HD and NHL involving the abdominal and pelvic lymph nodes,which is useful for the diagnosis,staging and therapy of HD and NHL.

关 键 词：淋巴瘤 淋巴结 腹部 体层摄影术 X线计算机 

分 类 号：R733.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]