影像学检查在肝移植术后肝门区淋巴组织增生性疾病中的诊断价值分析  

Diagnostic value of imaging examinations for hepatic portal posttransplant lymphoproliferative disorder after liver transplantation

作　　者：丁施文 吴晓冬[1] 杨子祯 许传屾[1] 蔡金贞 王建红[1] Ding Shiwen;Wu Xiaodong;Yang Zizhen;Xu Chuansen;Cai Jinzhen;Wang Jianhong(Organ Transplantation Center,Affiliated Hospital of Qingdao University,Qingdao 266100,China)

机构地区：[1]青岛大学附属医院器官移植中心,青岛266100

出　　处：《中华器官移植杂志》2023年第12期754-758,共5页Chinese Journal of Organ Transplantation

基　　金：山东省学校卫生协会科研课题(SDWS2022070);青岛大学附属医院"临床医学+X"科研项目(QYFY+X202101060)。

摘　　要：移植后淋巴组织增生性疾病(posttransplant lymphoproliferative disorder,PTLD)是器官移植较为严重的并发症之一。青岛大学附属医院器官移植中心2021年10月至2022年12月收治肝移植术后发生肝门区局部PTLD受者3例。常规B型超声检查表现为肝门区低回声肿物;增强CT检查表现为肝门区软组织密度影,不均匀强化;PET/CT检查表现为肝门区肿物代谢增高。其中2例行超声造影检查,1例表现为动脉早期高增强,门脉期及延迟期低增强,即"快进快出"征象;1例表现为"三期"(肝动脉期、门静脉期和延迟期)无增强。病理学检查报告,T/NK细胞性淋巴瘤2例,B细胞性淋巴瘤1例。结合既往文献分析与本次研究结果,常规B型超声常用于临床随访中检出早期PTLD病例,超声造影和增强CT有助于对PTLD的鉴别诊断,PET/CT对PTLD有较高的诊断准确性。Posttransplant lymphoproliferative disorder(PTLD)is one of the more serious complications of organ transplantation.From October 2021 to December 2022,3 patients with hepatic portal PTLD were hospitalized.Conventional ultrasonography hinted at hypoechoic area in porta hepatis.Enhanced CT revealed heterogeneous enhancement of soft tissue density in porta hepatis.PET/CT indicated higher metabolism of hilar mass.Two patients underwent contrast-enhanced ultrasound."Fast-in-and-fast-out"sign(n=1)and no enhancement in all stages(n=1)were noted.Pathological examination revealed T/NK cell lymphoma(n=2)and B cell lymphoma(n=1).In conjunctions with previous literature reports,conventional ultrasound is frequently employed for detecting early cases of PTLD during clinical follow-ups.Contrast-enhanced ultrasound and enhanced CT may aid in making a differential diagnosis of PTLD.And PET/CT has high diagnostic accuracy for PTLD.

关 键 词：肝移植 淋巴组织增生性疾病 超声造影 

分 类 号：R657.3[医药卫生—外科学]