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目的探讨MSCT直接淋巴管造影(DLG)在弥漫性淋巴管瘤病中的诊断价值。方法回顾性分析9例弥漫性淋巴管瘤病的影像学资料,5例行DLG及造影后胸、腹、盆部CT检查,余4例行CT检查。9例中3例行MRI检查。结果 9例中,8例累及脾,5例累及腋窝,5例累及颈部,5例累及腹腔及腹膜后,4例累及髂部及腹股沟,3例累及纵隔,3例累及腹壁,2例累及肺,1例累及肝,1例累及颅内硬膜下,CT表现为囊状低密度影,MRI表现为囊状长T1、长T2信号。8例累及骨,CT上表现为边界清楚的类圆形低密度影,MRI上表现为长T1、长T2信号。5例行DLG、造影后CT及胸导管探查示胸导管出口受阻,腹膜后淋巴管扩张迂曲。9例中有4例合并乳糜返流,1例合并锁骨上乳糜囊肿。结论弥漫性淋巴管瘤病影像学表现具有特异性,MSCT DLG可明确显示淋巴管的异常,可为其病因诊断及合并乳糜返流性疾病的治疗提供直接信息。
Objective To investigate the value of MSCT direct lymphangiography (DLG) in the diagnosis of diffuse lymphangioma. Methods The imaging data of 9 cases of diffuse lymphangioma were retrospectively analyzed. CT, CT scan of DLG and chest, abdomen and pelvis were performed in 5 cases and CT scan was performed in 4 cases. Three of the nine patients underwent MRI examination. Results Of the 9 cases, 8 cases involved the spleen, 5 cases involved the axilla, 5 cases involved the neck, 5 cases involved the peritoneal cavity and retroperitoneum, 4 cases involved the iliac crest and the groin, 3 cases involved the mediastinum, 3 cases involved the abdominal wall, 2 cases involved Lung, 1 case involved the liver, 1 case involved intracranial epidural, CT showed cystic low density, MRI showed cystic long T1, long T2 signal. 8 cases involving the bone, the CT showed a clear border-like low-density round shape, MRI showed long T1, long T2 signal. 5 cases of DLG, CT and chest CT angiography showed thoracic duct outlet blocked, retroperitoneal lymphatic dilation tortuous. 4 of 9 cases combined with chylorrhea, 1 case of supraclavicular chylomicrons. Conclusion The imaging manifestations of diffuse lymphangiomatosis are specific. MSCT DLG can clearly show the abnormality of lymphatic vessels, which can provide direct information for the diagnosis of etiology and the treatment of cholestatic reflux disease.