腹部巨淋巴结增生症的CT及MRI表现

CT and MRI Findings of Abdominal Castleman Disease

目的:分析腹部Castleman病(CD)的CT及MR影像学特征,以期提高对本病的影像学认识。方法:对10例经手术病理证实为腹部CD患者的CT及MRI表现进行回顾性分析。结果:本组病例有透明血管型(9例)和浆细胞型(1例);所有肿块边界清楚,形态规则,以椭圆形和或豌豆形居多。局灶肿块型9例,CT平扫均为等密度,3例肿块内可见钙化;动态增强扫描动脉期肿块明显强化,实质期5例病灶进一步持续性强化;4例强化稍退出;3例肿块周围可见扩张扭曲血管影。多发结节型1例,CT平扫呈均匀等密度,增强扫描动脉期轻中度强化,实质期进一步强化。本组4例行MRI扫描,平扫T1WI上低信号影,T2WI上为等或稍高信号影;动态增强扫描局灶肿块型病灶(3例)均明显且持续强化,肿块周围均可见完整包膜;多发结节型病灶(1例)呈轻中度强化。结论:CT及MRI动态增强多期扫描对腹部CD具有重要诊断价值。

Purpose: To evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of abdominal Castleman disease (CD), in order to improve the imaging understanding of the disease. Methods: The CT and MRI manifestations of 10 patients with abdominal Castleman disease confirmed by surgical pathology results were retrospectively analyzed. Results: The patients were with hyaline-vascular type (9 cases) and plasma-cell type (1 case); All the masses showed well-defined margins and regular shapes, most of which were ovoid or pea shapes. Nine cases of unicentric CD showed iso-density on plain CT, and calcification was seen in 3 cases. On dynamic CT examination, all 9 masses displayed obvious homogeneous enhancement during arterial phase, with further continuous enhancement in 5 cases and slightly washed out in 4 cases during parenchymal phase. Dilated and distorted vessels were shown in 3 cases. One case of multicentric CD in our group showed iso-density on plain CT, mild to moderate enhancement during arterial phase and further enhancement during parenchymal phase. In MRI scanning, all 4 cases showed hypointense on T1WI and isointense or slightly hyperintense on T2WI. Obvious and continuous enhancement and the complete capsular were seen in 3 cases of unicentric CD during dynamic contrast scanning. One case of multicentric CD displayed mild to moderate enhancement. Conclusion: CT and MRI dynamic enhanced multiphase scans have important diagnostic value for abdominal CD.