Waldeyer环淋巴组织增生及恶性淋巴瘤的MRI和CT研究

CT and MRI diagnosis of the lymph tissue proliferation and malignant lymphoma of Waldeyer′s ring

目的 :研究Waldeyer环淋巴组织增生及恶性淋巴瘤的MRI和CT表现及应用价值。方法 :对照分析 172例Waldeyer环淋巴组织增生及 2 1例恶性淋巴瘤的MRI和CT表现和手术、病理结果。结果 :172例咽部淋巴组织增生可发生于双侧咽扁桃腺、腭扁桃腺或舌根部、软腭等 ,也可沿咽壁弥漫肥厚、增生 ,引起口咽腔狭窄 ,其中 5 5例伴有睡眠时呼吸暂停综合症 (OSAS)。CT表现为增生组织或咽部弥漫性增厚 ,边界锐利 ,平扫为均匀等、高密度 ,可轻度均匀强化。MRIT1WI表现为等信号 ,T2 WI为高信号 ,颈部无肿大淋巴结。 2 1例恶性淋巴瘤有 10例发生在腭扁桃腺 ,3例在舌根部 ,均表现为向咽腔突出的类圆形软组织肿块 ;5例鼻咽和 3例咽侧壁淋巴瘤均表现为不规则的软组织肿块 ,病变范围较大 ,向四周弥漫生长 ,但无颅底及周围结构损害。MRI和CT可见肿块的密度和信号均匀 ,可轻度强化。 2 1例恶性淋巴瘤有 13例发现颈部淋巴结受侵。结论 :MRI和CT能清楚显示Waldeyer环淋巴组织增生和恶性淋巴瘤的部位、形态、范围以及有无颈部淋巴结受侵和周围组织的侵犯 。

Objective:To investigate the CT and MRI findings of the lymph tissue proliferation and malignant lymphoma of Waldeyer′s ring. Methods:172 cases of the lymph tissue proliferation and 21 cases of malignant lymphoma of Waldeyer′s ring were examined by CT and MRI.Diagnostic value of the CT and MRI finding were analyzed and correlated with their operation and pathology.Results:172 cases of lymph tissue proliferation were found in the bilateral tonsil of the pharynx,palate,bases of tongue or soft palate,and widespread tissue proliferation resulted in the pharyngeal narrowing.There were 55 out of 172 cases of obstructive sleep apnea syndrome (OSAS).CT scans displayed homogeneous isodense or hyperdense tissue proliferation with slight homogeneous enhancement.MRI showed isointensity on T_1WI and hyperintensity on T_2WI with slight enhancement after injection of Gd-DTPA There was no lymph node metastasis in the neck.In 21 cases of malignant lymphoma of Waldeyer′s ring,there were 10 cases in tonsil and 3 cases in the bases of tongue.They displayed soft tissue mass protruding into nasopharynx or pharynx.None of the base of skull was destroyed.The density on CT and signal on MRI of malignant lymphoma of Waldeyer′s ring were homogeneous with slight enhancement.The lymph nodes metastases in the neck were observed in 13 of 21 cases of malignant lymphoma. Conclusion:CT and MRI could indicate the location,morphology,surrounding tissue and lymph nodes metastases of the lymph tissue proliferation and malignant lymphoma of Waldeyer′s ring.They have great value in clinical diagnosis and treatment.