摘要
目的 探讨原发性肾上腺恶性淋巴瘤的CT、MR表现,以提高对该少见疾病的影像诊断水平。方法 回顾性分析20例经病理证实的原发性肾上腺恶性淋巴瘤的CT、MR表现,其中12例行CT平扫和增强检查,8例行MR平扫和增强检查。观察肿瘤的部位、大小、形态、边缘、CT密度或MRI信号及强化特征。结果 20例患者中,单侧9例,双侧11例,共31个病灶,肿瘤最大径约2.8~16.5cm,平均（8.2±0.6）cm;22个病灶呈边缘清晰、光整的类圆形或椭圆形肿块;9个呈边缘不光整、边界不清的不规则分叶状肿块,其中肿瘤侵犯肾上极3个,包绕下腔静脉2个,包绕门静脉主干、侵犯腰大肌各1个。密度或信号均匀26个,不均匀5个。CT平扫病灶呈等密度15个,稍低密度5个,所有病灶内均未见钙化及出血。MR平扫病灶T1WI呈等信号7个,低信号4个;T2WI呈高信号;DWI均呈高信号,ADC值平均（0.98±0.07）×10-3 mm2/s。增强后病灶轻度强化24个,中度强化7个。结论 原发性肾上腺恶性淋巴瘤影像表现多数为双侧肾上腺区域铸形生长、密度（信号）均匀、无明显钙化、轻-中度强化的占位灶,肿瘤大者可侵犯相邻结构,具有一定的特征性,CT、MR检查可以准确显示肿瘤累及的范围,为临床治疗提供有价值的信息。
Objective To explore the CT and MR imaging findings of primary adrenal lymphoma（PAL） in order to enhance the understanding of this rare disease. Methods A retrospective analysis of the CT（n=12） and MRI （n=8） findings was performed in 20 patients with pathologically proved PAL. CT and MR images were evaluated with respect to the following feature factors： location, size, morphology, margin, CT density/ MR signal intensity, and enhancement pattern. Results There were total 31 lesions in 20 patients. The maximum diameter of PAL ranged from 2.8 to 16. 5 cm, mean （8.2±0.6） cm. Twenty-two lesions demonstrated round or oval round masses with welbdefined margin, 9 lesions demonstrated irregular masses with ill-defined edge. Among them, the upper kidneys were infiltrated in 3 lesions, the inferior vena cava were wrapped around in 2 lesions, the portal vein was embedded and the Psoas major muscle was invaded in 1 lesion respectively. The densities or siganal intensities were homogeneous in 26 lesions and heterogeneous in 5 lesions. Compared to normal muscle, 15 lesions manifested as isodensity and 5 lesions manifested as slight low-density on CT plain scan. Lesions were isointense in 7 lesions and hypointense in 4 lesions on T~ WI, hyperintense in all lesions on T2W1 and DWI. After intravenous injection of contrast media, 24 lesions demonstrated mild enhancement, 7 lesions demonstrated moderate enhancement. Conclusion Most of PAl. manifested as soft tissue masses in bilateral adrenal gland with homogeneous density or siganal intensities and slight to moderate enhancement. The larger lesions were likely to invade the adjacent structure. CT and MR examinations can accurately demonstrate the extent of tumor involvement and are helpful to provide more comprehensive information for clinical management.
出处
《医学影像学杂志》
2015年第10期1843-1847,共5页
Journal of Medical Imaging
基金
浙江省卫生高层次人才培养基金(浙财社2013-189)
关键词
淋巴瘤
肾上腺
体层摄影术
X线计算机
磁共振成像
Lymphoma
Adrenal gland
Tomography, X-ray computed
Magnetic resonance imaging
