腹部局限型Castleman病的CT和MRI诊断

CT and MRI Diagnosis of Localized Castleman's Disease of Abdomen

目的:探讨腹部局限型Castleman病的CT和MRI表现及其诊断价值。方法:回顾性分析经手术病理证实的6例腹部局限型Castleman病影像资料,其中5例行CT检查,1例行MRI检查。结果:4例病变位于腹膜后,2例位于肠系膜。病理分型,透明血管型5例和浆细胞型1例。CT检查5例,平扫密度较均匀,边界清晰锐利,1例伴有钙化,1例见卫星灶,增强扫描动脉期2例肠系膜肿块以及1例肾上腺区域肿块明显强化,密度均匀,门静脉期持续强化;1例胰头后方肿块中等均匀强化,1例肾上腺区域肿块中等程度周边不规则强化,门静脉期强化范围扩大。2例肠系膜肿块以及1例胰头后方肿块内部和周边可见粗大、扭曲的血管影。MRI检查1例,肿块位于后腹膜下腔静脉旁,T1WI低信号,T2WI高信号,信号均匀,边界清晰锐利,增强扫描动脉期均匀强化,门静脉期持续强化。结论:CT是诊断腹部局限型Castleman病的重要影像学手段,影像学表现与病理类型密切相关,多数透明血管型病变具有一定的特征。

Objective：To evaluate the CT and MRI features of localized Castleman＇s disease of abdomen. Methods;CT findings of 5 cases and MRI findings of 1 case with surgery and pathology proved abdominal localized Castlemanls disease were retrospectively analyzed. Results：The location of lesions were as follows：mesentery （n 2） ,retroperitoneum （n=4）. As for histopathologic classification,there were hyaline-vascular type （n 5） and plasma cell type （n=1）. CT appearances of these 5 patients were well-defined soft tissue mass with homogeneous attenuation;intra tumoral calcification and satellite lesions were assessed in 1 case each. After contrast administration,marked homogeneous enhancement was showed in arteri al phase in rnesenteric lesion （n=2） and in mass at adrenal area （n=1）,which were consistently enhanced in portal venous phase;moderate homogeneous enhancement in 1 case with lesion located posterior to the pancreatic head;moderate peripheral irregular enhancement in 1 case located at adrenal area,and the enhanced area enlarged in portal venous phase. Enlarged and tortuous vessels could be revealed within the mesenteric mass （2 patients） as well as the intra tumoral and periphery of the mass posterior to the pancreatic head （1 patient）. Of the 1 patient had MRI,the lesion located at retroperitoneum adjacent to inferior vena cava, showing hypo-intensity on T1 WI, hyper intensity on T2 WI, with well-defined margin, homogeneously enhanced on arterial phase and consistently enhanced on portal vein phase. Conclusion：CT plays an important role in the diagnosis of localized Castleman＇s disease of abdomen, CT findings were closely correlated with pathology subtypes, characteristic features could be revealed in most of the hyaline vascular type.