CT增强扫描在鉴别Castleman病病理类型中价值的研究

The Research of CT Enhanced Scan in Differential Pathologic Types of Castleman's Disease

目的探讨CT增强扫描在鉴别透明血管型和浆细胞型Castleman病中的价值。方法回顾性分析14例经病理证实CD的CT平扫及增强病例资料,测量增强扫描各期CT值并作统计学分析。结果 11例为透明血管型,3例为浆细胞型,均为弥漫型(共6个病灶)。11例透明血管型患者平均年龄为(35.92±15.58)岁,浆细胞型为(52.67±8.96)岁,统计学差异有意义(P<0.05);透明血管型CT_(平扫)、CT_(动脉期)、CT_(静脉期)、CT_(动脉平扫)、CT_(静脉-动脉)的平均CT值分别为(42.30±4.37)HU、(126.01±26.20)HU、(106.65±18.54)HU、(86.05±24.63)HU、(-20.71±26.07)HU;浆细胞型CT_(平扫)、CT_(动脉期)、CT_(静脉期),CT_(动脉-平扫)、CT_(静脉-动脉)的平均值分别为(50.77±14.55)HU、(98.09±10.62)HU、(88.08±13.73)HU、(47.14±9.96)HU、(-9.61±4.80)HU;两种病理类型中CT_(动脉期)、CT_(静脉期)、CT_(动脉-平扫)差异有统计学意义(P<0.05、P<0.05,P<0.05),CT_(平扫)和CT_(静脉-动脉)差异无统计学意义(P>0.05,P>0.05)。结论年龄、CT_(动脉期)、CT_(静脉期)、CT_(动脉-平扫)在鉴别透明血管型和浆细胞型CD具有重要意义。

Objective To investigate the value of CT enhancement scan in distinguishing pathological type of Castleman disease（CD）. Methods The CT enhancement scan and pathology features of 14 cases with CD proved by pathology were analyzed retrospectively. The CT value of plain scan, arterial phase, venous phase were recorded with statistical analysis. Results 11 cases with local distribution were hyaline vascular subtype and 3 cases with disseminated type were plasma subtype pathologically （6 masses in total ）. The average age of hyaline vascular subtype is 35.92 ± 15.58 and 35.92 ± 15.58 in plasma subtype with no statistic difference （P =0. 028）. The CT value of plain scan, arterial phase, venous phase, the difference of arterial phase and plain scan, venous phase and arterial phase of hyaline vascular subtype were 42.30 ± 4.37, 126.01 ± 26.20, 106.65 ± 18.54, 86.05 ± 24.63, - 20.71 ±26.07 ; plasma subtype were 50.77± 14.55, 98.09 ± 10.62, 88.08 ± 13.73,47.14 ±9.96, -9.61 ±4.80. There were statistical difference in arterial phase, venous phase, and the was difference between the arterial phase and plain scan. There was no statistical difference in CT value of plain scan and the difference of venous phase and arterial phase（P = 0. 217, P = 0.323 ）. Conclusion The average CT value of arterial phase, venous phase and the difference of arterial phase and plain scan play a significant role in distinguishing hyaline vascular subtype and hyaline vascular subtype of CD.