大肠淋巴瘤的影像学表现

目的：复习大肠淋巴瘤的影像学表现，以期对原发大肠淋巴瘤在术前提出诊断，尽早发现继发大肠淋巴瘤。材料与方法：１７例经手术或活检证实的大肠淋巴瘤，行钡剂或双对比灌肠造影１６例，ＣＴ扫描９例。结果：１７例均为非何杰金淋巴瘤，原发５例，继发５例，初诊时即属Ⅳ期７例。病变累及１段结肠１２例，同时或先后有多于１段结肠受累５例。钡灌肠造影见扁平盘状隆起２例，孤立结节１例（２个），单发肿物６例，肠腔狭窄８例，全部结肠多发结节伴回盲部全周狭窄１例。ＣＴ扫描见肠壁增厚４例，结节或肿块４例，腹腔、盆腔、腹膜后淋巴结肿大３例，肝、脾受侵及回盲部肠套叠各１例。结论：钡灌肠及ＣＴ扫描是互补的检查方法，分别提供粘膜及肠壁和肠外的病变情况。大肠淋巴瘤常表现为轮廓光整的结节或肿物（４７％），肠壁增厚（４７％），肿大淋巴结（３３．３％）。病变罕见向周围脂肪浸润。

Diagnostic significance of ultrasonography and CT for large upper abdominal mass

OBJECTIVE: To assess the effect of ultrasonography and computerized tomography (CT) in the diagnosis of large upper abdominal mass. METHODS: Data from 43 cases that were clinically and pathologically confirmed were retrospectively analyzed and the effect of their preoperative ultrasonography and CT was compared. RESULTS: Four of 10 (40 percent) cases of liver mass were diagnosed correctly using ultrasonic device, nineteen of 25 (76 percent) cases of adrenal gland mass and 2 of 4 cases of kidney mass. Two of 10 (20 percent) cases of liver mass were correctly diagnosed by CT, and so were 6 of 22 (27.2 percent) cases of adrenal gland mass. In 4 patients with spleen mass, neither ultrasonography nor CT diagnosis was correct. CONCLUSION: Because upper abdomen organs are closely connected with each other, correct imaging localization of a large mass in this region is not easy. In this study, we compared the accuracy of ultrasonography and CT in diagnosing large upper abdominal masses, and found that ultrasonography works better for adrenal rather than liver or kidney. Neither ultrasonography or CT could accurately diagnose a large mass in the spleen.

肾癌亚型MRI表现与病理特点的相关性分析

目的探讨肾细胞癌亚型的MRI特点。方法经手术切除并病理证实的肾癌患者234例（244灶）。男167例，女67例。年龄24～78岁，中位年龄53．5岁。肿瘤最大径0．8～20．0cm，平均6．2cm。TNM分期T1 135例（57．7％）、T2 41例（17．5％）、T3 31例（13．2％）、T4 27例（11．5％）。结合病理改变回顾性分析其MRI表现特点。结果透明细胞癌199例（209灶），MRI表现为平扫不均匀信号（90．0％）及不均匀中、重度强化（88．4％），病理表现主要为出血（27．8％）、坏死（46．4％）及囊性改变（23．9％）。乳头状肾细胞癌10例（灶），平扫信号不均匀（90．0％），增强扫描轻度（60．0％）强化，90．0％强化不均匀；内部可见囊变（50．0％）、出血（70．0％）。嫌色细胞癌13例（灶），平扫信号较均匀（69．2％），增强扫描多为均匀信号（66．7％）及轻度强化（91．7％），出血、坏死及囊性改变少见。未分类型12例（灶），呈不均匀信号及强化（83．3％）。结论肾癌各亚型MRI表现及病理改变有一定差异，嫌色细胞癌多为较均匀信号及轻度强化，乳头状癌多表现为不均匀信号及轻度强化，易囊变及出血，透明细胞癌与未分类型多为不均匀信号及中重度强化。肾癌MRI表现及病理特点对肾癌亚型的诊断与鉴别诊断有一定意义。