原发性肠道淋巴瘤CT诊断20例分析

An Analysis of Diagnosis with CT for 20 Cases with Primary Intestinal Tract Lymphoma

[目的]探讨原发性肠道淋巴瘤的CT诊断价值。[方法]回顾性分析20例CT扫描后经病理证实的原发性肠道淋巴瘤的部位、形态、范围及强化特征。[结果]20例中局限型15例,多发节段型5例;20例中肠壁环形增厚型17例,其中8例见肠腔呈动脉瘤样扩张,肠腔内肿块型2例,肠壁环形增厚与肠腔内肿块型并存1例。17例环形增厚的肠壁3例呈规则环形增厚,14例呈不规则环形增厚,肠壁厚薄不均,但黏膜面较光整,未见明显强化及增厚的黏膜层。20例中15例伴发肠系膜和(或)腹膜后多发肿大淋巴结,其中6例见“夹心面包征”,增强后肠壁及肿大淋巴结多为中等均匀强化。20例中3例并发肠套叠,7例伴有肠系膜、大网膜条索状和结节状增厚及腹腔积液。[结论]原发性肠道淋巴瘤具有一定的特征性CT表现,典型病例可对其作出定性诊断。

[Purpose] To explore the diagnostic value of CT in primary intestinal tract lymphoma （PITL）. [Methods] CT images in 20 eases with PITL pathologically proved were retrospectively analyzed in term of their position, shape, scope and enhanced feature. [Results] Twenty cases with PITL included 15 eases of localized type and 5 cases of muhistage type. Of the 20 cases, 17 cases showed howel-wall toroid thickening （3 regtdar thickening and 14 eases irregular tbiekening）; 8, ＂aneurisma]＂ sign; 2. luminal mass and 1, bowel-wall toroid thickening combined with luminal mass. Fifteen cases accompanied with mesenteric and/or retroperitoncal lymph nodes enlargement, 6 cases of which showed ＂sandwich＂ sign. Three cases combined with intassuseeption, and 7 vases accompanied with mesenterium and colic omentum thickening and seraperitoneum.[Conclusion] The CT appearances of PITL have certain characteristics and can be made qualitative diagnose in typical cases.