肺内淋巴瘤的影像诊断

目的 探讨肺内淋巴瘤的影像学特征及表现.方法 选择2016年3月-2020年6月收治的30例肺内淋巴瘤患者为研究对象,均行CT、腹部超声检查,其中行气管分叉和肺内病灶薄层扫描检查12例,其余行常规胸部CT检查18例,回顾性分析临床资料.结果 所有患者均顺利完成检查,可见多发或单发肺肿块、结节,其中可见空洞4例,可见空气支气管征8例,病灶边缘表现为磨玻璃样或者棉絮状25例;合并双肺多发栗粒结节6例,合并双肺磨玻璃样变或细网状结构20例;同时,肺假性淋巴瘤8例,主要以空气支气管征为主的双肺多发大片浸润为主要表现,无肺门及纵隔淋巴结肿大.结论 肺淋巴结影像表现呈现出多样化的特点,往往合并肺间质变、肺内斑片影,应该及时行病理检查,减少漏诊或误诊.     

肺黏膜相关淋巴组织淋巴瘤的CT诊断

目的 研究肺黏膜相关淋巴组织(MALT)淋巴瘤的CT表现,提高对该病的认识及鉴别诊断能力.方法 回顾性分析经病理证实的12例MALT淋巴瘤的CT表现,影像观察指标为病灶的数量、分布、形态、密度及伴随征象.结果 12例MALT淋巴瘤中共检出肺实变、肺肿块、肺结节、磨玻璃样病灶32个,病灶单发2例,多发10例;多发病例中单肺多发2例,双肺多发8例.肺实变10例共21个病灶,其内均可见支气管充气征,1例2个病灶内见支气管扩张;肺肿块或结节影3例共5个病灶,3个病灶内可见支气管充气征;磨玻璃样改变2例共6个病灶;1例伴纵隔及肺门淋巴结肿大.结论 MALT淋巴瘤CT上常表现为双肺多发、含有支气管充气征的肺实变、肿块、结节样或磨玻璃样改变;上述影像表现及相对缓慢的病变过程提示MALT淋巴瘤的诊断.     

肺黏膜相关淋巴组织淋巴瘤CT表现

目的 了解肺黏膜相关淋巴组织淋巴瘤CT征象.资料与方法 回顾性分析经病理细胞学和免疫组织化学证实17例肺黏膜相关淋巴组织淋巴瘤CT表现.结果 单肺与双肺病灶分别为6、11例,单发与多发分别为4、13例,肺内病灶总数30个,其中包括14个肺实变影、9个肿块影和7个结节影,支气管充气征和小囊腔14例,胸腔积液4例,淋巴结肿大7例.结论 CT对诊断肺黏膜相关淋巴组织淋巴瘤有一定帮助.     

肺炎性假瘤CT诊断

目的:探讨肺炎性假瘤的CT表现特征,以提高影像诊断水平.方法:回顾性分析22例经开胸手术病理证实的肺炎性假瘤患者术前CT检查资料,其中8例CT平扫、11例CT增强、3例同时进行CT平扫和增强,分别对病灶的发生部位、大小、形态以及增强前后的病灶进行CT分析.结果:病灶位于右肺13例,左肺9例,表现为实变影11例,其中合并巨大囊性占位1例,显示空气支气管征2例;周围型不规则肿块影11例,其中多发占位1例,合并结节状钙化1例;病灶大小:1.5cm×2.0cm～6cm×5cm,灶内见单发或多发类圆形空洞影15例,实性部分CT值平扫22.4HU(16.6～28.3HU),增强后45s80.76HU(49～89.48HU).纵隔淋巴结肿大7例.结论:肺炎性假瘤表现多样,以实变和周围型不规则肿块影常见,灶内常有大小不等单发或多发脓肿影,实变区病变明显强化.     

肺黏膜相关淋巴组织型淋巴瘤的影像表现

目的 探讨肺黏膜相关淋巴组织型(MALT)淋巴瘤CT或18F-脱氧葡萄糖(FDG)PETCT表现及其诊断价值.方法 回顾性分析14例经手术及病理证实的肺MALT淋巴瘤的CT或18F-FDG PET-CT表现特点.结果 单肺病灶7例,双肺病灶7例,其中单发实变影3例,单发肿块影3例,单发结节影1例,多发结节影1例,肿块影合并结节影、斑片状影1例,实变影合并斑片状影4例,弥漫性间质性病变1例.9例有支气管充气征,5例有CT血管造影征.2例FDG代谢不均匀增高,最大标准摄取值超过2.5.结论 肺MALT淋巴瘤的影像特征性表现主要为单发或多发结节、肿块或实变影,内有支气管充气征,18F-FDG高代谢,确诊主要依靠病理组织学和免疫组织化学.

Abstract：

Objective To assess the value of CT or PET-CT with fluorine-18-labeled fluorodeoxyglucose (FDG) for the diagnosis of pulmonary mucosa-associated lymphoid tissue (MALT) type lymphoma. Methods The CT or FDG PET-CT findings in 14 patients with pathologically proved pulmonary MALT lymphoma were retrospectively analyzed. Results Lung lesions were unilateral in 7 patients and bilateral in 7 patients. Lesions presented as a single mass in 3 patients, as a single consolidation in 3 patients, as a nodule in 1 patient, as multiple nodules in 1 patient, as multiple patchy consolidations in 4 patients, as a mass with multiple nodules and patchy consolidations in 1 patients, as diffuse interstitial change in 1 patients. Air bronchogram was found in 9 patients and CT angiogram sign in 5 patients. On PET-CT, lesions showed heterogeneous FDG uptake in 2 patients, maximum standard uptake value was higher than 2. 5. Conclusion Imaging characteristics of pulmonary MALT lymphoma are single or multiple nodules or consolidations with air bronchogram on CT, and heterogeneous high FDG uptake on PET-CT.     

肺黏膜相关淋巴组织淋巴瘤的CT和临床表现及其病理学基础

目的:探讨肺黏膜相关淋巴组织(MALT)淋巴瘤的CT表现特征及与其临床、病理表现的关系.方法:回顾性分析22例经病理确诊的肺MALT淋巴瘤患者的影像学和临床资料.22例中2例合并肺癌,5例同时有肺外累及.结果:本组患者的主要临床症状包括咳嗽咳痰12例、喘憋7例、发热4例、胸痛2例、咯血2例、盗汗2例,有2例患者无明显症状.22例的主要表现可分为2型,实变型16例(16/22,73％),肿块/结节型7例(7/22,32％).病灶密度均匀15例(15/22,68％),增强扫描均明显强化,可见血管造影征;病灶边缘均可见晕征,空气支气管征19例(19/22,86％),伴支气管扩张15例(15/22,68％).其它表现包括肺内多发小结节14例(64％),磨玻璃影11例(50％),树芽征4例(18％),胸腔积液9例(41％),肺门及纵隔淋巴结增大6例(27％).合并肺癌者CT表现为肺内单发肿块伴周围明显间质性浸润.结论:肺MALT淋巴瘤的临床表现无特异性,但其CT表现有一定特征性,对本病的诊断及鉴别诊断有重要的提示作用,确诊需依靠病理活检.     

肺黏膜相关淋巴瘤的CT表现(附10例报告及文献复习)

目的 探讨原发性肺黏膜相关淋巴瘤的CT表现.方法 对10例病理证实的肺黏膜相关原发淋巴瘤的CT特征及病理进行分析讨论.结果 10例在CT上存在不同范围的肺实变,在所有实变的病灶中见空气支气管征,并且部分病灶中可见有支气管扩张症及肺大泡,磨玻璃样改变或间质网格状改变分布在实变的边缘部位.病灶均无坏死,空洞及钙化存在.无胸膜增厚及胸腔积液,无肺门及纵隔淋巴结肿大.结论 肺黏膜相关原发淋巴瘤的CT表现只有肺和(或)支气管受侵而无淋巴结的肿大;此表现有助于本病的诊断.     

肺黏膜相关淋巴组织型淋巴瘤的CT表现分析

目的 探讨肺黏膜相关淋巴组织型(MALT)淋巴瘤的CT表现,提高对该病的认识及诊断水平.方法 回顾性分析13例经手术及病理证实的肺MALT淋巴瘤CT表现.结果 (1)单发病灶4例,多发病灶9例,其中多发实变5例,多发肿块结节合并间质性改变3例,多发磨玻璃影1例;(2)实变影11个病灶,均见扩张“空气支气管征”,3例跨叶分布;结节共41枚,其中分叶34枚,边缘模糊31枚,胸膜下分布27枚,沿支气管血管束分布11枚,“细支气管征”或“空泡征”28枚;肿块9枚,均为分叶状,边缘模糊7枚,“空气支气管征”7枚.结论 肺MALT淋巴瘤常表现为两肺多发实变、结节和肿块,扩张“空气支气管征”对诊断有提示意义;多发分叶状肿块和跨叶分布的实变,多发的胸膜下或沿支气管血管束分布的伴“细支气管征”或“空泡征”的分叶状结节,应考虑MALT淋巴瘤的可能.     

肾上腺区副脾的CT表现

目的 探讨肾上腺区副脾的CT特征.方法 回顾性分析经手术病理证实的5例肾上腺区副脾术前CT资料.结果 病灶均位于左侧肾上腺区,单发,边界清晰,4例呈类圆形,1例椭圆形,最大径1.1 ～3.0 cm之间,平均(2.1±0.7)cm.CT平扫5例病灶密度均匀,与同层面的脾脏密度相近,均无囊变、坏死、出血及钙化,CT值41.9～55.3 HU,平均(47.7±5.4)HU;增强动脉期均明显不均匀或斑马纹样强化,CT值78.6～141.1 HU,平均(102.6±25.8) HU,静脉期2例进一步强化,3例强化程度略减低,强化程度均趋于均匀,CT值68.7 ～ 129.7 HU,平均(104.6±22.9) HU.5例病灶3期CT值与同层面脾脏的CT值相仿,5例中,病灶由脾动脉分支供血4例,合并其他部位的副脾2例.结论 肾上腺区副脾CT特征为平扫密度及强化程度均相近,多由脾动脉分支供血,易合并其他部位的副脾,这些特征有助于肾上腺区副脾的诊断.     

脾脏淋巴瘤的CT诊断价值

目的:探讨脾脏淋巴瘤的CT特征性表现,提高影像学诊断水平.方法:回顾性分析了经病理学证实的19例脾脏淋巴瘤的CT形态学的表现和强化方式.结果:19例患者脾脏体积测量为415.32～4196.15cm3,平均(1615±709.7) cm3.脾脏肿大17例(17/19,89.5％).肿块型病灶直径＞3cm2例(2/19,10.5％);结节型病灶直径＜3cm单发性4例(4/19,21.1％),多发性11例(11/19,57.9％);弥漫型病灶直径＜5mm 2例(2/19,10.5％).CT平扫时病灶中心区CT值约为(40.43±9.44) HU;增强后动脉期病灶中心区CT值约为(51.46±13.42) HU,静脉期病灶中心区CT值约为(66.36±21.71) HU,CT平扫时病灶中心区与增强后的动、静脉期病灶密度差异有统计学意义(P＜0.001).结论:CT能很好地显示脾脏淋巴瘤的病灶形态学改变和CT强化特点,可明显提高脾脏淋巴瘤诊断的准确性.     

Principles of CT and CT technology

This article provides a review of the basic principles of CT within the context of the evolution of CT. Modern CT technology can be understood as a natural progression of improvements and innovations in response to both engineering problems and clinical requirements. Detailed discussions of multislice CT, CT image quality evaluation, and radiation doses in CT will be presented in upcoming articles in this series.     

Principles of CT: multislice CT

This article describes the principles and evolution of multislice CT (MSCT), including conceptual differences associated with slice definition, cone beam effects, helical pitch, and helical scan technique. MSCT radiation dosimetry is described, and dose issues associated with MSCT-and with CT in general-as well as techniques for reducing patient radiation dose are discussed. Factors associated with the large volume of data associated with MSCT examinations are presented.     

PET/CT in malignant melanoma: contrast-enhanced CT versus plain low-dose CT

Purpose  

The aim of this study was to evaluate the diagnostic value of contrast-enhanced CT (CECT) versus non-enhanced low-dose CT (NECT) in the staging of advanced malignant melanoma with ¹⁸F-fluordeoxyglucose (FDG) positron emission tomography (PET)/CT.     

Multidetector CT and CT angiography in mesenteric ischemia

Purpose

To evaluate the role of 64-multidetector CT in assessment of mesenteric vascular ischemia in clinically suspected patients.

Patients and methods

This study included 38 patients during period from October 2009 to October 2011. The patients age ranged from 38 to 72 year old (mean age was 57 ± 11.2 years). All cases met the criteria of acute non traumatic (28 patients) or chronic abdominal pain (10 patients) and suspected mesenteric vascular ischemia. All 38 cases were evaluated in surgery department, then underwent CT of the abdomen and pelvis & CTA by using 64 multislice GE light speed VCT. MDCT& CT angiographic findings were correlated with surgical findings in acute mesenteric ischemia (AMI) cases & conventional angiography in chronic mesenteric ischemia (CMI) cases.

Results

MDCT findings alone were nonspecific for detection of MI. The sensitivity, specificity& accuracy of CTA in diagnosis of AMI after surgical confirmation were 96%, 66.6% & 92.8% respectively, while in CMI the sensitivity, specificity & accuracy were 88.8%, 100%, 90% respectively, after confirmation by conventional angiography.

Conclusion

CTA scan appears to be an excellent tool to find out and localize cases of AMI rather than in CMI cases.     

CT扫描参数对人体组织CT值影响的研究

目的 探索不同CT扫描参数对人体同一种组织CT值的影响。方法 通过在同一台CT机上,分别改变其中1个扫描参数,如X线管电压、毫安秒和重建函数等,而保持其他扫描参数不变,多次扫描标准体模,测量和分析体模中不同物质的CT值。结果 X线管电压的改变对物质的CT值影响具有显著意义。聚乙烯、聚碳酸酯、有机玻璃的CT值与管电压成正相关;聚四氟乙烯的CT值与管电压成负相关。毫安秒和重建函数对CT值的影响差异无统计学意义。结论 同一个人体组织在不同的X线管电压条件下CT值是变化的。因此,在临床影像诊断和放疗中应该考虑图像扫描参数的设置对诊断和治疗结果的影响。     

CT angiography

The advent of spiral (helical, volume ) CT has revolutionised the performance of body CT and allowed the development of CT angiography (CTA). CT angiography is a non-invasive method of visualising the vascular system and in some instances can replace conventional angiography. In spiral CT a volume of data is obtained rapidly with no respiratory misregistration at peak vascular opacification following the peripheral injection of contrast. Appropriate timing will ensure that either the venous or arterial tree is visualised and from the volume of data multiple overlapping slices can be obtained to generate 2D and 3D images with no increase in radiation to the patient. CT angiography may be performed as a dedicated study or be undertaken retrospectively using post-processing of data from a conventional diagnostic spiral scan to provide additional information about the vascular tree. When undertaken as a dedicated study CTA is quicker, less invasive and less costly than a conventional angiogram with a decrease in the radiation dose to the patient; however, the spatial resolution is limited with vessels less than 2 mm not visualised and there is no contrast saving. Received: 25 March 1998; Revision received: 16 July 1998; Accepted: 22 July 1998