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【目的】分析总结不同部位胃肠道淋巴瘤的多层螺旋CT表现及鉴别诊断。【方法】回顾性分析135例经手术病理证实的胃肠道淋巴瘤患者,就胃肠道淋巴瘤的发生部位、病理类型及多层螺旋CT表现进行分析和讨论。所有病例均采用GE lightspeed 16或Siemens Somatom Definition 64层双源螺旋CT扫描。【结果】胃淋巴瘤发生率最高(69例),其次为小肠淋巴瘤(40例)。最常见的病理类型是弥漫大B淋巴瘤(87例)及MALT淋巴瘤(24例)。大多数胃淋巴瘤(60例)表现为胃壁增厚,但未见明显梗阻征象,增强扫描14例可见黏膜白线征。动脉瘤样扩张(9例)、病灶内积气(3例)及“夹心面包征”(2例)则是小肠淋巴瘤的特征性表现。结直肠淋巴瘤少见(26例),CT表现与小肠淋巴瘤相似。【结论】胃肠道淋巴瘤的MSCT表现具有一定特异性,特别是回肠淋巴瘤,有助于胃肠道淋巴瘤的诊断及鉴别诊断。
【Objective】 To summarize the multi-slice spiral CT findings and differential diagnosis of gastrointestinal lymphoma at different sites. 【Methods】 A retrospective analysis of 135 cases of gastrointestinal lymphoma confirmed by surgery and pathology was performed. The location, pathological type and multi-slice spiral CT findings of gastrointestinal lymphoma were analyzed and discussed. All cases were scanned with GE lightspeed 16 or Siemens Somatom Definition 64-layer double-source spiral CT. [Results] The highest incidence of gastric lymphoma (69 cases), followed by intestinal lymphoma (40 cases). The most common pathological types are diffuse large B lymphoma (87 cases) and MALT lymphoma (24 cases). The majority of gastric lymphoma (60 cases) showed gastric wall thickening, but no obvious signs of obstruction, enhanced scan of 14 cases of visible white line signs of mucosa. Aneurysmal dilatation (n = 9), intraluminal foci (n = 3), and “sandwich loaf” (n = 2) were characteristic features of small intestinal lymphoma. Colorectal lymphoma is rare (26 cases), CT findings and intestinal lymphoma similar. 【Conclusion】 MSCT manifestation of gastrointestinal lymphoma has certain specificity, especially ileal lymphoma, which is helpful to the diagnosis and differential diagnosis of gastrointestinal lymphoma.