原发性胃淋巴瘤的X线和CT诊断

目的:提高原发性胃淋巴瘤(PGML)的X线和CT诊断水平。方法:收集21例经胃镜活检和手术证实为原发性胃淋巴瘤。其中行胃肠气钡双对比造影(GI)检查7例,CT检查17例,两者均行检查3例。分析其GI和CT表现。结果:21例PGML中,GI表现为多发结节状充盈缺损5例,胃底、体多发肿块1例,胃腔扩张及收缩良好5例。CT表现为胃壁增厚17例,伴有肿块4例,形成直径2.5cm以上大溃疡4例。17例胃壁均增厚为0.6cm～4cm,14例(82.3%)增厚胃壁增强幅度为14HU～25HU的轻、中度强化。增厚胃壁强化均匀15例,见小片状坏死2例。肝脏均未见转移性病灶。结论:原发性胃淋巴瘤主要位于胃窦和胃体,GI主要表现为多发结节状充盈缺损或多发肿块,CT主要表现为浸润型,密度均匀,呈轻、中度均匀强化,可伴有大溃疡形成,在GI检查或CT三期扫描中胃的形态可变。

Radiographic and CT diagnosis of primary gastric malignant lymphoma

Objective:To improve radiographic and CT diagnose of primary gastric malignant lymphoma(PGML).Methods:Twenty one cases of PGML proved pathologically by gastroscope and operation were collected,7 patients received double-contrast upper gastrointestinal examinations(GI),17 received CT examinations,and 3 received the both examinations.The GI and CT findings were analysed.Results:Tumor mainly involved gastric antrum(18 cases,85.7%) and body(17 cases,81%) and involved gastric antrum and body(15 cases,71.4%) simultaneously.The GI findings:5 cases of multiple nodule filling defect,1 case of multiple masses in gastric bottom and body,5 cases of normal dilation and contraction.The CT findings:17 cases of mural thickening with the thickness between 0.6cm~4cm,4 cases of masses,4 cases of ulcers.14 cases(82.3%) of the thickened wall enhanced mildly or moderately,15 cases enhanced homogeneously and 2 cases of little patchy necrosis were seen in thickened wall.14 cases(82.3%) were infiltrating type,3 cases were mass type and 4 cases were ulcer tupe.No metastasis in liver was found.Conclusion:Primary gastric malignant lymphoma mostly involves gastric antrum and body and GI findings were mostly multiple nodules or masses,CT findings were mostly infiltrating type with homogeneous density and mild or moderate enhancement,accompanied with large ulcer.The gastric modality is variable in GI and CT three-phase scan.