纵膈内淋巴瘤的CT诊断与鉴别研究

A Study of CT Diagnosis and Identification of Mediastinal Lymphoma

目的研究纵膈内淋巴瘤CT诊断与鉴别价值。方法回顾性分析经病理证实30例纵膈内淋巴瘤患者的CT影像学资料,观察总结纵膈内淋巴瘤位置、大小、形态、密度等CT表现,并与病理结果比较。结果与病理结果比较,CT诊断纵膈内淋巴瘤准确率90.0%(27/30),另3例均误诊为纵膈胸腺瘤。均淋巴结肿大,且以多发淋巴结肿大为主;肿大淋巴结全部融合占26.7%,表现出分叶状或波浪状不规则软组织肿块;CT平扫多为均匀密度,增强扫描以均匀增强为主,占90.0%;血管移位21例(70.0%);胸骨、肋骨前段骨质破坏、胸壁软组织包块与心包积液、胸腔积液各8例。结论多层螺旋CT诊断纵膈内淋巴瘤准确率高,可作为纵膈内淋巴瘤诊断、鉴别的重要手段之一。

Objective To study the value of CT in diagnosis and identification of mediastinal lymphoma. Methods CT imaging data of 30 patients with mediastinal lymphoma confirmed by pathology were retrospectively analyzed. The CT findings such as the location, size, shape and density of the mediastinal lymphoma were observed and compared with pathological findings, Results Compared with the pathological findings, the accurate rate of CT in diagnosis of mediastinal lymphoma was 90,0% （27/30）. Another 3 cases were misdiagnosed as mediastinal thymoma. All were lymphadenectasis and mainly were multiple lymphadenectasis; All swelling lymph nodes fusion accounted for 26.7%, showing lobulated or wavy irregular soft tissue masses. CT plain scan mainly showed homogeneous density and enhancement scan mainly was hontogeneous enhancement, 0 （70.0%） were with vascular displacement. There were accounting for 90.0%. 21 cases anterior segment of bone destrnction of sternum and rib, chest wall soft tissue masses and pericardial effusion and pleural effusion in respctively 8 cases. Conclusion The accurate rate of multi＇slice spiral CT in the diagnosis of mediastinal lymphoma is high. It can be used as an important method for diagnosis and identification ofmediastinal lymphoma.