腹盆腔局灶性透明血管型Castleman病与低度恶性胃肠道外间质瘤的MSCT表现比较

目的探讨腹盆腔局灿性透明血管型Castleman病(HV-LCD)的CT表现,并与低度恶性胃肠道外间质瘤(EGIST)比较,以提高诊断准确率。方法回顾性分析经手术、病理确诊的HV-LCD14例和EGIST23例,分析两者临床及CT特征,并对两者的CT表现进行比较。结果与低度恶性EGIST相比,HV-LCD具有直径较大(5.77±1.38,t=2.409,P=0.021),病灶内低密度影相对少见(28.6%,x^(2)=5.450,P=0.020),呈裂隙样改变,钙化多见(42.8%,x^(2)=4.5,P=0.042),呈树枝状、弧形钙化影,强化方式主要表现为“速升缓降-平台型”(92.8%,x^(2)=15.53,P<0.001),肿瘤周边常见结节状增粗、迂曲血管影(62.3%,x^(2)=6.698,P=0.010)。两者形态、边缘、强化程度、增强后病灶内供血血管、动脉期最高CT值比较,差异无统计学意义(P>0.05)。结论腹盆腔HV-LCD的CT表现具有一定特征性,MSCT增强扫描有助于两者鉴别诊断。

Objective To explore CT manifestations of localized hyaine-vascular type of Castleman's disease(HV-LCD)in abdomen and pelvis and low-grade malignant extra-gastrointestinal stromal tumors(EGIST),and further to compare their CT features in order to improve the differentiate diagnosis HV-LCD from EGIST.Methods Imaging manifestations of 14 cases of patients with HV--LCD and 23 cases with EGIST confirmed by surgical pathology were analyzed retrospectively and compared,their CT findings were evaluated.Results Compared with lowe-grade malignant EGISTs,the MSCT of HV-LCDs in abdomen and pelvis were more frequently demonstrated bigger size(5.77±1.38,t=2.409,P=0.021),less low low-density inside(28.6%,x^(2)=5.450,P=0.020),linear and slit-like low-density on plain or enhanced CT imaging,more punctuate,bifurcation,circumferential calcification in the centre(42.8%,x^(2)=4.5,P=0.042),slowly rising slowly down dynamic enhancement pattern(92.8%,x^(2)=15.53,P<0.001),enlarged nutritious blood vessels around the mass(62.3%,x^(2)=6.698,P=0.010)。There was po significant difference in shape,margin,the degree of enhancement,nutritious blood vessels inside the tumors,maximum CT value(P>0.05)。Conclusion The imaging finding of HV-LCD has certain characteristics.The MSCT enhancement are helpful for the differential diagnosis of both tumors.