原发性肠道淋巴瘤的多层螺旋CT表现

The Multi-slice CT Features of Primary Intestinal Lymphoma

目的 探讨原发性肠道淋巴瘤(primary intestinal lymphoma,PIL)的多层螺旋CT表现,以提高此类肠道肿瘤诊断准确率。方法 回顾性分析经病理证实的23例原发性肠道非霍奇金淋巴瘤CT征象,包括肿瘤部位、累及肠管长度、肠壁增厚程度、动/静脉期强化程度、淋巴结数目及大小。所有病例均行CT平扫及增强扫描。结果 8例PIL位于小肠,5例回盲部,4例同时累及回肠末端和升结肠,4例升结肠,2例直肠。病灶累及肠段范围较长或呈多节段分布,均表现为不同程度肠壁增厚,部分病例可于狭窄肠腔内见残留气体影,少数继发肠套叠、肠梗阻、肠内瘘。大多数病灶增强扫描轻中度强化。动脉瘤样扩张及淋巴结“夹心面包”征是肠道淋巴瘤特征性表现。结论 原发性肠道淋巴瘤具有特征性CT表现,有助于诊断与鉴别诊断。

Objective To investigate the multi-slice CT(MsCT) features of primary intestinal lymphoma(PIL) and to improve the accuracy of diagnosis of this kind of intestinal cancer. Methods Enhanced Ms CT data of 23 patients with primary intestinal non-Hodgkin’s lymphoma proved pathologically were retrospectively analyzed, including the tumor location, length of intestinal lesions, thickening of intestinal wall, degree of enhancement, number and size of lymphonodus. All patients underwent CT plain scan and enhanced scan, Results The lesions located at the small intestine in 8 cases, 5 cases at the ileocecum, 4 cases at the terminal ileum and ascending colon, 4 cases at the ascending colon and 2 cases at the rectum. CT images showed long-range or multicentric intestinal lesions, a various degrees of thickening of intestinal wall. Residuary gas in narrow intestinal lumen were detected in some cases, a few cases were combined with intussusception, ileus and intestinal fistula. Meanwhile, mild to moderate enhancement of the lesions were found in the majority. Aneurysmal dilatation and ‘sandwich’ sign were the characteristic CT features of PIL. Conclusion PIL has typical imaging features in CT scanning, CT scanning is helpful for the diagnosis and differential diagnosis of PIL.