原发性胰腺淋巴瘤的CT、MRI和PET/CT表现  

CT,MRI and PET/CT Findings of Primary Pancreatic Lymphoma

作　　者：陈伯柱 孙双双 仇毓东[2] 伏旭[2] 史炯[3] 唐敏[1] CHEN Bozhu;SUN Shuangshuang;QIU Yudong;FU Xu;SHI Jiong;TANG Min(Department of Medical Imaging,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University,Nanjing 210008,China;不详)

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,江苏南京210008 [2]南京大学医学院附属鼓楼医院胆胰外科,江苏南京210008 [3]南京大学医学院附属鼓楼医院病理科,江苏南京210008

出　　处：《中国医学影像学杂志》2023年第11期1168-1171,共4页Chinese Journal of Medical Imaging

摘　　要：目的总结原发性胰腺淋巴瘤(PPL)的CT、MRI和PET/CT表现,提高对本病的认识。资料与方法回顾性分析2017年1月—2021年12月南京大学医学院附属鼓楼医院4例PPL的临床及影像资料。患者均行胰腺CT平扫及增强扫描、上腹部MRI及全身PET/CT检查。重点分析病灶的部位、大小、形态、强化方式、周围血管情况、信号特点、胰胆管改变、累及范围,并测量病灶的最大标准化摄取值。结果4例患者中腹痛2例,黄疸1例,体检发现1例。发生于胰头3例,病灶长径5.2~11.4 cm。CT平扫呈低密度,MRI呈稍长T1稍长T2信号,扩散加权成像明显弥散受限,病灶轻中度均匀强化,1例出现坏死囊变,4例病灶均包绕周围血管,包绕动脉未见明显狭窄,受累静脉狭窄2例。PET/CT均为明显高代谢灶,最大标准化摄取值为9.2~21.3。术前影像正确诊断2例,误诊为胰腺癌1例、肿块性胰腺炎1例。结论PPL的影像学表现具有一定特征,加深对其影像学表现的认知可减少误诊。Purpose To summarize the CT,MRI and PET/CT findings of primary pancreatic lymphoma(PPL).Materials and Methods The clinical and imaging data of four patients with pathologically confirmed PPL from January 2017 to December 2021 in Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University were retrospectively reviewed.All four patients underwent pancreatic CT plain and enhanced scans,upper abdominal MRI examinations,and whole-body PET/CT examinations.We mainly focused on the location,size,morphology,enhancement pattern,involvement of peripheral blood vessels,signal characteristics,cholangiopancreatography changes and extent of the lesion.Besides,we also measured the maximum standardized uptake value of the lesion.Results These four patients,symptoms included abdominal pain(two cases)and jaundice(one case)and one case showed no symptoms and was found during imaging examination.The masses,ranging from 5.2 to 11.4 cm,were mainly located in the pancreatic head(three cases).All cases showed low density on CT plain scan.On MRI,the masses showed slightly low intensity T1 and slightly high intensity T2,and obvious diffusion restriction.All masses showed slight to moderate enhancement,only one case showed necrosis.Of four cases with vascular embedding,there were two cases with venous stenosis.On PET/CT,all masses showed hypermetabolism with maximum standardized uptake value ranging from 9.2 to 21.3.Two cases were preoperatively diagnosed with accuracy as pancreatic lymphoma,while one case was misdiagnosed as pancreatic cancer and one case as focal pancreatitis.Conclusion Imaging findings of PPL have certain characteristics,increased awareness of these findings may reduce misdiagnosis.

关 键 词：胰腺肿瘤 淋巴瘤 磁共振成像 体层摄影术 X线计算机 体层摄影术 发射型计算机 

分 类 号：R735.9[医药卫生—肿瘤] R733.4[医药卫生—临床医学] R445