脾脏弥漫大B细胞淋巴瘤的CT和MRI特征

CT and MRI Features of Diffuse Large B Cell Lymphoma in the Spleen

目的探讨脾脏弥漫大B细胞淋巴瘤(DLBCL)的CT和MRI特征。方法搜集14例经病理证实的脾脏DLBCL的临床及影像资料,回顾性分析脾脏DLBCL的CT和MRI特征。结果14例脾脏DLBCL中,脾肿大12例,占比85.7%。单发肿块8例,占比57.1%;多发肿块6例,占比42.9%。CT平扫呈等、低密度各4例,等低混杂密度6例;类圆形9例,不规则形5例;平扫边界不清/欠清13例,边界清楚1例。增强扫描不均匀轻中度强化,强化程度低于正常脾脏;增强扫描边界清楚11例,边界不清/欠清3例。14例中有9例发现腹膜后多发肿大淋巴结,其中7例出现血管"漂浮"征。脾静脉瘤栓1例。MRI检查6例,T1WI和T2WI表现为混杂信号,DWI表现为高低混杂信号,增强扫描病灶实性成分不均匀轻中度强化,坏死囊变区无强化。结论脾脏DLBCL的CT和MRI表现具有特征性,多表现脾脏肿大,伴单发或多发肿块,易坏死囊变,CT平扫呈等、低或混杂密度,T1WI和T2WI表现为混杂信号,增强扫描不均匀轻中度强化,典型者呈"地图"样表现。

Objective To investigate the CT and MRI features of splenic diffuse large B-cell lymphoma.Methods The clinical and imaging data of 14 cases of pathologically confirmed spleen DLBCL were collected.The CT and MRI features of splenic DLBCL were analyzed retrospectively.Results Among the 14 cases of spleen DLBCL,7 cases were male and 7 cases were female;age ranged from 35 to 83 years old.Splenomegaly was found in 12 cases(85.7%).Single mass was found in 8 cases(57.1%),multiple mass in 6 cases(42.9%).On plain scan CT,there were 4 cases of equal and 4 cases of low density,6 cases of equal and low hybrid density.There were 9 cases of quasi circle,5 cases of irregular shape.There were 13 cases of unclear/unclear boundary and 1 case of clear boundary.The enhancement was not uniform,mild or moderate,and the enhancement degree was lower than that of normal spleen.After enhancement,the boundary was clear in 11 cases and unclear in 3 cases.Among the 14 cases,9 cases were found to have multiple enlarged lymph nodes,7 of which had"floating"sign of blood vessels.One case of splenic vein tumor thrombus.6 cases accepted MRI.On T1WI and T2WI,the lesions appeared mixed signal.On DWI,appeared high and low mixed signal.After enhancement,the solid components of the lesions were uneven,light and moderate enhancement,and no enhancement was found in necrotic cystic area.Conclusion The CT and MRI manifestations of DLBCL in the spleen are characteristic,most of which show splenomegaly,with single or multiple masses,necrotic cystic change easily.On plain scan CT,DLBCL shows equal,low or mixed density.DLBCL appears mixed signal On T1WI and T2WI,and uneven light and medium enhancement on enhanced scan,typical of which shows"map like"performance.