肝脏原发性淋巴瘤的MR诊断价值及鉴别诊断

The value of MR diagnosis and differential diagnosis of primary hepatic lymphoma

目的探讨肝脏原发性淋巴瘤(PHL)的MRI表现,旨在提高对该病的诊断水平。方法回顾性分析经手术、CT或超声引导下穿刺后病理证实并行MRI检查的PHL 8例,分析PHL的MRI表现。结果本组病例PHL均为单发病变,T1WI所有病变均呈低信号,T2WI呈高信号,DWI呈特征性的高信号,多数信号均匀,边界清晰。增强扫描呈无明显强化或轻~中度强化,1例可见不规则坏死;6例病灶内可见血管穿行其中,而血管未见确切狭窄及包绕等受累征象,呈血管漂浮征。结论肝脏原发性淋巴瘤以单发多见,DWI呈明显高信号、增强扫描呈少血供及血管漂浮征可能具有一定的特征性。结合临床相关资料,可提高疾病诊断的准确性。

Objective To analyze MRI findings of primary hepatic lymphoma(PHL)for improving its recognition and diagnostic accuracy.Methods 8 patients with PHL confirmed by pathology of operation,CT or ultrasound guided puncture were reviewed retrospectively.All cases were perfomed MRI and MRI findings of PHL were analyzed.Results All 8 PHL cases presented solitary lesion.On MR T 1WI imaging,all lesions were presented as hypointensity,on MR T 2WI imaging,all lesions showed hyperintense,on MR DWI imaging,all lesions showed distinctive hyperintense,most signals were uniform and the boundary was clear.Enhanced MRI showed no evident enhancement or slight to moderate enhancement,1 case had irregular necrosis.Blood vessel traverse lesions and the vessels were not narrowed and encircled in 6 cases.Conclusion Most PHL presented solitary lesion,on MR DWI imaging,all lesions showed distinctive hyperintense.Enhanced MRI showed less blood supply and blood vessel floating sign.Combined with clinical information,the diagnostic accuracy of PHL could be improved.