肾脏淋巴瘤CT检查的影像学特点

Diagnostic value of CT scan in kidney lymphoma

目的总结CT检查诊断肾脏淋巴瘤的影像学特点。方法回顾性分析14例经穿刺或手术病理证实为。肾脏淋巴瘤的CT影像表现。男8例，女6例。平均年龄53（9～68）岁。临床表现腹部不适9例、腹泻3例、腹痛2例，伴血尿2例、发热2例。采用Somatom Plus4型螺旋CT机和Presto多层螺旋CT机，平扫加增强扫描12例，动脉期加实质期扫描2例。总结分析肾脏淋巴瘤CT检查的直接征象和间接征象。结果14例患者CT检查的直接征象：单发结节型1例，病灶密度均匀，增强后较明显均质强化，边缘清楚；多发结节型6例，增强后结节边缘清楚。呈轻度均质强化或强化不明显，肾外形无明显外凸；弥漫浸润型7例，肾脏肿大，病灶轻度强化，境界不清楚。间接征象：腹主动脉、。肾门旁多发淋巴结肿大13例，其中淋巴结肿大成串或成堆4例，淋巴结广泛肿大融合，包绕血管，显示“腹主动脉淹没”征3例。13例淋巴结肿大密度均匀，轻度强化，其中边缘清楚、光整9例。伴骶椎、骶管淋巴瘤1例、肾周筋膜浸润2例。右。肾手术切除1例，穿刺活检证实13例，病理报告均为B细胞型非霍奇金淋巴瘤。结论肾脏淋巴瘤的CT诊断及鉴别诊断除直接征象外，典型间接征象有重要意义。

Objective To discuss the diagnostic value of CT scan in kidney lymphoma. Methods Review the CT findings of 14 cases with kidney lymphoma proved by pathology. Eight cases were male and the other 6 cases were female, the average age was 52- year-old. Nine cases showed abdominal discomfort, 2 cases showed abdominal pain, 3 cases showed diarrhea, 2 cases were accompanied with hematuria and 2 cases were with fever. Using Somatom Plus4 spiral CT and 4-slice Presto mdhi-slice spiral CT, plain scan and enhanced scan were carried out in 12 cases, arterial phase scan plus parenchymal phase scan were carried out in 2 cases. The direct and indirect signs were analyzed. Results The CT performance of 14 cases. Direct sign： Single node was in 1 case, which manifested uniform density on plain scanning and uniformly on contrast, the border was clear. Multiple nodes were in 6 cases,which presented clear border and lightly enhanced, the kidney＇s shape had no significantly outer convex. Diffusely invading tumor were in 7 cases,which had the finding of enlarged kidney. lightly enhanced lesions and ambiguous border. Indirect sign： the lymphoma nodes beside ab dominal aortor and renal hilus enlaged were in 13 cases,in which the lymphoma nodes enlarged like ar ray were in 4 cases, the lymphoma nodes swelled and fused, enveloped vessels, showed ＂abdominal aortic submerged sign＂ were in 3 cases. The lymphoma nodes swelled with uniform and lightly enahanced density were in 13 cases, in which the lymphoma nodes had clear border were in 9 cases, accompanied with sacral vertebra, sacral lymphoma was in 1 case,with perinephrium invasion were in 2 ca ses. The right kidney Surgically resected was 1 case, biopsy confirmed were 13 cases, pathology reports were all B-cell non-Hodgkin lymphoma. Conelusion For diagnosis of kidney lymphoma, the indirect typical signs have great importance besides direct important signs