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1、臨床放射學(xué)雜志2014年第33卷第8期·1205·腹部放射學(xué)原發(fā)性肝臟淋巴瘤的影像學(xué)表現(xiàn)胡慧娟,廖關(guān)焱,田志雄,彭碧榮【摘要】目的探討原發(fā)性肝臟淋巴瘤(PHL)的CT及MRI影像學(xué)表現(xiàn),以提高對該病的診斷水平。方法回顧性分析l6例PHL患者的CT及MRI影像學(xué)特點(diǎn)。結(jié)果16例病理組織學(xué)檢查均為非霍奇金淋巴瘤,免疫組織化學(xué)示10例為B細(xì)胞表型,6例為T細(xì)胞表型;8例呈單發(fā)腫塊,6例為多發(fā)結(jié)節(jié)、腫塊,2例為多發(fā)斑片狀結(jié)節(jié);12例病變邊界較清晰,4例邊界模糊。CT平掃均表現(xiàn)為低或稍低密度;增強(qiáng)掃描動(dòng)脈期病灶強(qiáng)化不明顯,呈輕-中度強(qiáng)化,較正常肝組織強(qiáng)化弱;門靜脈期病灶強(qiáng)化稍
2、加強(qiáng),延遲期強(qiáng)化減弱;12例行MRI掃描,在TwI上均表現(xiàn)為低信號(hào),T2WI上均表現(xiàn)為高信號(hào),其內(nèi)信號(hào)較均勻;增強(qiáng)掃描呈輕.中度強(qiáng)化,4例呈周邊環(huán)形強(qiáng)化,1例腫瘤中可見血管走行,類似“血管漂浮征”。結(jié)論肝臟原發(fā)淋巴瘤可單發(fā)或多發(fā),邊界大部分較清晰,CT平掃呈低密度,密度相對較均勻,增強(qiáng)呈輕一中度均勻強(qiáng)化或周邊環(huán)形強(qiáng)化,部分病灶內(nèi)可見類似“血管漂浮征”。CT及MRI能夠清晰顯示腫瘤的部位、數(shù)目、形態(tài)、內(nèi)部結(jié)構(gòu)及血供情況等,對肝臟淋巴瘤的診斷有較大價(jià)值?!娟P(guān)鍵詞】原發(fā)肝淋巴瘤非霍奇金淋巴瘤體層攝影術(shù),X線計(jì)算機(jī)磁共振成像ImagingFindingsofPrimaryH
3、epaticLymphomaHUHutjuan,LIA0Meiyan,TIANZhixiong,eta1.CTRoom,ZhongnanHospitalofWuhanUniversity,Wuhan,HubeiProvince430071,P.R.China【Abstract】ObjectiveToinvestigatetheimagingfeaturesofprimaryhepaticlymphoma(PHL)SOastoimproveitsdi—agnosticaccuracy.MethodsCTandMRIfindingsinsixteenpatientswi
4、thpathologically—provedPHLwereretrospectivelyanalyzed.ResultsPathologicalexaminationshowedthatallthesixteencasessufferedfromnon·Hodgkinlymphoma(NHL).Immunohistochemicalexaminationindicatedthat10patientshadB—cellNHLand6patientshadT-cellNHL.A—mongthesixteencases,solitarylivermasswasseeni
5、neight,multiplenodulesinsix,andmultiplespecklednodulesintwo.Thelesionwaswelldefinedin12cases,andthelesionhadavaguemarginin4cases.OnplainCTscanning,allle—sionswerecharacterizedbylow—densityorslightlylow—densityareaswithoutobviousenhancementinarterialphase,onlymildormoderatedegreeofenhan
6、cementcouldbeseen,theenhancementdegreewasweakerthanthatofthenormallivertissue.Thelesiongenhancementwasslightlyincreasedinportalphaseanddecreasedindelayedphase.MRIscanningwascarriedoutin12cases,andthelesionsweremanifestedashomogeneoushypo-intensitysignalonTlWIandhomogeneoushyper—intensi
7、tysignalonT2WI.DynamicGd—DTPAenhancedMRIscanningdemonstratedthatthelesionsshowedslight—moderateenhancement,withperipheralring—shapedenhancementin4cases.Bloodvesselswithinthelesionwereseeninonecase,whichwasregardedas“bloodvesselfloating”sign.ConclusionThelesionofPHLcanbesingleormultip