肺黏膜相关淋巴组织淋巴瘤的CT与MRI影像特征分析  

CT and MRI manifestations of pulmonary mucosa-associated lymphoid tissue lymphoma

作　　者：陈晨[1] 谢可欣 邹俊婷 陈静[1] 曾亮[1] CHEN Chen;XIE Kexin;ZOU Junting;CHEN Jing;ZENG Liang(Department of Radiology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京中医药大学附属医院放射科,江苏南京210029

出　　处：《影像研究与医学应用》2024年第11期24-29,共6页Journal of Imaging Research and Medical Applications

基　　金：江苏省教育科学“十四五”规划基金资助(B/2021/01/44)。

摘　　要：目的:分析肺黏膜相关淋巴组织(MALT)淋巴瘤的CT与MRI影像特征,以提高其影像诊断水平。方法:收集2010年4月-2023年6月于南京中医药大学附属医院经病理确诊的34例肺MALT淋巴瘤病例,回顾性分析其临床资料与CT、MRI影像特征。其中,有23例患者行CT增强扫描,3例患者(共11处病灶)行MRI平扫+增强检查。结果:34例肺MALT淋巴瘤患者中,结节肿块型与肺炎实变型分别占47.1%、44.1%,双侧、多发病灶分别占55.9%、58.8%,病灶沿胸膜下+支气管周围分布约占44.1%,跨叶分布发生率约为26.5%。CT重要的影像特征包括:中重度均匀强化(95.5%)、血管造影征(86.3%)、肺间质增厚(61.8%)、支气管扩张(58.8%)、合并肺囊肿(55.9%)、毛刷状边缘(52.9%)等;MRI重要的影像特征包括:平扫序列信号均匀(100.0%)、低ADC值[(0.878±0.382)×10^(-3)mm^(2)/s]、中重度均匀强化(81.8%)、平台型/流出型时间-信号强度曲线(TIC)(100.0%)。结论:肺MALT淋巴瘤影像表现复杂,形态、分布模式、密度及信号均匀、中-重度均匀强化、血管造影征、支气管扩张、低ADC值、平台型/流出型TIC曲线等征象有助于肺MALT淋巴瘤的诊断。Objective This study aims to conduct a thorough analysis of the CT and MRI imaging features associated with pulmonary mucosa-associated lymphoid tissue(MALT)lymphoma,to enhance diagnostic accuracy.Methods 34 cases of pulmonary MALT lymphoma confirmed by pathology at Affiliated Hospital of Nanjing University of Chinese Medicine from April 2010 to June 2023 were collected.A retrospective analysis encompassing clinical characteristics,alongside detailed scrutiny of CT and MRI imaging manifestations,was conducted.Notably,23 patients underwent CT contrast-enhanced examinations,and 3 patients(accounting for a total of 11 lesions)underwent chest MRI plain scan and enhanced examination.Results In the cohort of 34 patients with pulmonary MALT lymphoma,the nodular mass pattern,and pneumonia-like consolidation pattern accounted for 47.1%and 44.1%respectively.Bilateral and multiple lesions were observed in 55.9%and 58.8%of the cases,respectively.Lesions distributed along the subpleural and peribronchial regions accounted for 44.1%,with a cross-lobe distribution rate of approximately 26.5%.The important features of CT include moderate to severe homogeneous enhancement(95.5%),angiogram signs(86.3%),pulmonary interstitial thickening(61.8%),bronchial dilation(58.8%),coexisting pulmonary cysts(55.9%),and brush like margins(52.9%).The essential MRI features include homogeneous signal intensity in the non-enhancement sequence(100.0%),low apparent diffusion coefficient(ADC)value[(0.878±0.382)×10^(-3) mm^(2)/s],moderate to severe homogeneous enhancement(81.8%),and platform/washout type time-signal intensity curve(TIC)(100.0%).Conclusion The imaging manifestations of pulmonary MALT lymphoma exhibit inherent complexity.Recognition of morphological nuances,distinct distribution patterns,moderate to severe homogeneous enhancement,angiogram signs,bronchial dilation,low ADC values,and platform/washout type TIC collectively contribute to the correct diagnosis of pulmonary MALT lymphoma.

关 键 词：肺黏膜相关淋巴组织淋巴瘤 原发性肺淋巴瘤 计算机体层成像 磁共振成像 

分 类 号：R445[医药卫生—影像医学与核医学]