胃原发性淋巴瘤的MDCT诊断价值

MDCT in the Diagnosis of Primary Gastric Lymphoma

目的探讨PGL的多排螺旋CT表现,提高其术前的诊断正确率。方法回顾性分析经临床病理证实的10例PGL患者的临床及CT特点。结果 10例PGL,9例为DLBCL,1例为MRLT。4例于胃窦,3例于胃体中,胃窦胃体2例,胃底、贲门1例;多期扫描过程中,6例胃壁形态发生变化,4例无变化;8例胃粘膜显示连续,并明显强化,2例显示不连续;6例肿瘤未累及胃浆膜面,4例累及浆膜面;5例胃周出现肿大淋巴结;PGL累及胃壁平均厚度为(1.7±0.9)cm;平扫及两期增强扫描,CT值分别为(31.7±6.9)HU,(45.9±10.9)HU,(56.9±12.7)HU;两期增强扫描CT增值分别为(14.2±11.9)HU,(25.2±14.8)HU;两期增强扫描分别与平扫CT值比较以及两期之间CT值比较,P值均<0.01;两期扫描绝对增值比较,P值<0.01。结论 PGL具有一定的CT特征,MDCT对PGL的诊断有一定价值。

Objective To explore the primary gastric lymphoma＇ s manifestation characteristic of multidetector CT, and develop the diagnostic accuracy. Methods The features of MDCT and clinic of 10 cases of patho-verified PGL were retrospectively analyzed. Resules There were 10 cases of PGL including 9 cases of DLBCL and 1 case of MALT.Four lesions were located in the sinus ventriculi,three lesions were located in the corpus ventriculi,two lesions were located in the sinus and corpus ventriculi and one lesion was located in the Gastric cardia.In the Multi-phase scanning process, six cases of gastric morphological had changed and four cases had no changes.8 cases of gastric displayed continuously gastric mucosa and significantly enhanced and two cases showed discontinuities in gastric mucosa. Six cases not involving the gastric serosa tumors, four cases involving the serosa surface. Gastric lymph nodes appear in five cases. The average thickness of the stomach wall was （1.7± 0.9） cm. On plain ,arterial portal vein phase, CT values were （31.7 ± 6.9） HU, （45.9±10.9） Hu and （56.9 ± 12.7） HU respectively. CT value-increasing between plain and arterial phase was （14.2 ± 11.9） HU, and between plain and portal vein phase was （25.2 ± 14.8） HU. Compared with each value,there were statistically significant difference（P〈0.01）. Conclusion PGL has some CT features, MDCT could be helpful in differential diagnosis of PGL .