摘要
目的探讨原发性肝脏淋巴瘤(primary hepatic lymphoma,PHL)的CT及MRI表现,并与病理结果对照分析,旨在提高对该病的认识和诊断。方法回顾性分析经手术、CT或超声引导下穿刺后病理证实的PHL8例,7例行CT检查,5例行MRI检查,其中4例同时进行了CT及MRI检查。分析PHL的CT及MRI表现。结果 PHL8例,其中单发7例,多发1例。CT表现:平扫所有病变均呈低密度,绝大多数密度均匀,边界清楚;MRI表现:T1WI所有病变均呈低信号,T2WI呈稍高/高信号,DWI呈特征性的高信号。CT及MRI增强扫描病灶呈无明显强化或轻-中度强化,1例出现不规则坏死;4例显示血管穿过病灶,而血管本身无明显狭窄、包绕等受侵表现。单发病例中1例呈肝段分布,误诊为脂肪肝,多发1例误诊为转移瘤。病理证实为弥漫大B细胞淋巴瘤7例,小淋巴细胞性淋巴瘤1例。结论 PHL呈乏血供肿瘤表现,增强扫描病灶内有血管穿过而血管本身无明显受侵(即血管漂浮征)可能具有一定特征。结合临床相关资料,可提高其诊断准确性。
Objective To analyze CT and MRI findings of primary hepatic lymphoma(PHL)and compare with the pathological results for improving its recognition and diagnostic accuracy.Methods 8 patients with PHL confirmed by pathology of operation,CT or ultrasound guided puncture were reviewed retrospectively.7 cases were perfomed CT,5 cases were perfomed MRI and 4 cases were perfomed CT and MRI.CT and MRI findings of PHL were analyzed.Results In all 8 PHL cases,7 cases presented solitary lesion,1 case presented multiple lesions.Unenhanced CT showed hypodense lesions in all cases,Most of the density were uniform and the boundary were clear;On MR T1WI imaging,all lesions were presented as hypointensity,on MR T2WI imaging,all lesions showed hyperintense,on MR DWI imaging,all lesions showed distinctive hyperintense.Enhanced CT and MRI showed no evident enhancement or slight to moderate enhancement,1 case had irregular necrosis.Blood vessel traverse lesions and the vessels were not narrowed and encircled in 4 cases.1 case of isolated lesions showed segmental distribution of liver and were misdiagnosed as fatty liver,the multiple lesions misdiagnosed as metastatic tumor.Pathology confirmed diffuse large B cell lymphoma in 7 cases,small lymphocytic lymphoma in 1 case.Conclusion PHL were confirmed hypo-vascular tumor.Blood vessel traversing lesions without narrowing or encircling may be a characteristic sign.Combined with clinical information,the diagnostic accuracy of PHL could be improved.
作者
管彬
钟唐力
刘启榆
林华
何川东
谢刚
谢春燕
GUAN Bin;ZHONG Tang-li;LIU Qi-yu(Department of Radiology,Mianyang Central Hospital,Mianyang 621000,Sichuan Province,China)
出处
《中国CT和MRI杂志》
2018年第2期1-3,30,共4页
Chinese Journal of CT and MRI
