腹部局限型Castleman病的影像学分析

目的分析腹部Castleman病(CD)的影像学表现,提高腹部CD的诊断准确性.方法收集12例经外科手术后病理检查证实的腹部局限型CD的临床资料,分析腹部CD的影像学表现.结果腹部CD患者12例,男7例,女5例;年龄32~70岁,平均(49.41±13.79)岁,5例位于腹腔内肠系膜根部,4例位于腹膜后间隙,2例位于肝脏,1例位于盆腔.12例均为单发肿块,边界均较清晰,肿块平均(7.25±4.25)cm.CT平扫为软组织密度,9例病灶内可见钙化灶.2例行MRI检查,平扫T1W1上呈等信号,T2WI上呈较高信号;内部信号较均匀,弥散加权成像序列(DWI)呈不同程度高信号.CT/MRI增强后表现为显著强化,9例具有持续强化表现,4例病灶内或周边可见滋养血管.结论腹部局限型CD的影像学表现具有一定的特征性,病变多边界清楚且均匀显著强化,病变内或周边滋养血管及钙化灶或为该病相对特异征象.

Objective To analyze the imaging fearures of abdominal Casleman disease(CD)and improve the diagnostic accuracy of abdominal CD.Methods The clinical data of 12 patients with focal abdominal CD confirmed by pathology afer surgery were collected and the imaging features of abdominal CD were analyzed.Results There were 12 patients with abdominal CD,including 7 males and 5 females with an average age of(49.41±13.79)years,ranged from 32 to 70 years old.Five cases were located in the mesenteric root,4 in the rttroperitoneal space,2 in the liver and 1 in the pelvic cavity.All the 12 cases were single mass with clear boundary,with an average of(7.25±4.25)cm.CT scan showed soft tssue density and calcification in 9 cases.MRI examination of 2 cases showed isointensity on T1WI and high signal on T2W1;intermal signal was uniform,and difiusion weighted imaging(DWI)showed varying degrees of high signal.Enhanced CT/MRI showed significant enhancement,9 cases had continuous enhancement,and 4 cases with nutrient vessels.Conclusion The imaging findings of focal abdominal CD have certain characteristics.The lesion has clear boundary and uniform enhancement.The nuttient vessels and calcification in or around the lesions may be relatively specific feaures of the disease.