原发性胃肠道淋巴瘤多层螺旋CT表现

目的探讨原发性胃肠道淋巴瘤的 CT 表现.资料与方法回顾性分析经手术病理证实的13例胃肠道淋巴瘤患者的多层螺旋 CT 表现及其病理特征.结果13例均为非霍奇金淋巴瘤,其中弥漫大 B 细胞淋巴瘤9例,黏膜相关边缘带 B 细胞淋巴瘤4例.胃部病变6例,其中累及全胃1例,胃窦2例,胃体1例,同时累及胃体及胃窦2例;小肠病变2例,其中空肠1例,回肠末端1例;结肠病变5例,其中回盲部2例,升结肠1例,乙状结肠1例,直肠1例.多层螺旋 CT 可见胃肠壁弥漫性增厚病灶伴管腔明显狭窄;病灶轻至中度增强;个别出现瘤样扩张征象及肠系膜和(或)腹膜后淋巴结肿大.结论多层螺旋CT 诊断原发性胃肠道淋巴瘤具有胃肠管壁弥漫性或局限性增厚;密度均匀,轻至中度均匀强化,轨道征、黏膜白线征及强化均匀等影像学特征,对胃肠道淋巴瘤具有一定的诊断价值.     

MSCT对胃肠道淋巴瘤的诊断价值研究

目的探讨多层螺旋CT平扫和增强扫描对胃肠道淋巴瘤的诊断价值。方法收集2011年1月~2014年7月在我院经内镜检查,并行CT扫描及术后病理活检证实的胃肠道淋巴瘤30例。所有病例均采用Black Ledge的分期方法进行临床分期。对胃肠道淋巴瘤的发生部位,病变厚度、分期、病理结果、平扫和增强的资料进行分析。结果胃淋巴瘤与肠道淋巴瘤的平扫、增强CT值比较无明显差异,两者的病变厚度比较有显著性差异(P0.05);MALT与其他胃肠道淋巴瘤的平扫、增强CT值比较无明显差异,病变厚度比较有显著性差异(P0.05);MALT与胃肠道淋巴瘤发生部位的关系表明:MALT在胃部发生率较高,而非MALT在肠道中发生占绝大多数(λ2=5.68,P=0.021);胃肠道淋巴瘤病变部位与病变分级的关系表明:胃肠道淋巴瘤较其他部位多发,且进展较快,如果发现了肠道淋巴瘤,大多数情况下都已经处于晚期。结论多层螺旋CT主要是用来诊断胃肠道淋巴瘤的,目前已经成为一种非常有效的方法,胃肠道淋巴瘤有多种CT表现形式,弥漫浸润型和多发肿块结节型是其两种主要的CT表现类型,CT平扫和增强可以明确病变部位,病变侵袭范围,周围淋巴结肿大情况,为胃肠道淋巴瘤的进一步临床治疗提供可靠依据。     

空回肠常见原发恶性肿瘤的多层螺旋CT诊断

目的 初步总结空回肠常见恶性肿瘤的临床病理特点及多层螺旋CT的诊断价值.方法 回顾性分析24例空回肠恶性肿瘤的病理特点及多层螺旋CT表现.结果 小肠腺癌12例,CT表现为密度不均、边界不清的肿块,呈明显强化,其中9例伴肠梗阻;恶性胃肠道间质瘤9例,CT表现为圆形或类圆形肿块,边界相对较清,周边部分明显强化,MIP像呈"抱球样"表现;小肠原发淋巴瘤3例,CT表现为环状或结节状肠壁增厚,密度较均匀,呈轻度强化.结论 空回肠常见的3种类型恶性肿瘤,多层螺旋CT增强扫描有助于定性诊断.     

原发性输尿管淋巴瘤1例并文献复习

目的探讨原发性输尿管淋巴瘤的多层螺旋CT表现。方法回顾分析经手术病理证实的1例输尿管淋巴瘤的多层螺旋CT表现并复习相关文献进行总结。结果本例CT显示右肾萎缩,肾盂积水扩张,右侧输尿管全程增粗,走行自然无僵直,管壁间断性不均匀增厚,局部管腔狭窄,输尿管远端可见不规则软组织密度影突入膀胱,边界欠清,增强扫描右肾未见明显强化,输尿管病变轻度强化。结论原发性输尿管淋巴瘤呈跳跃式分布,走行较自然,增强扫描病变区轻度强化。多层螺旋CT增强检查可为输尿管淋巴瘤的首选检查方法。     

MSCT在小肠肿瘤诊断中的临床价值

目的 探讨多层螺旋CT在小肠肿瘤性疾病诊断中的临床应用价值.方法 回顾性分析经手术及病理证实的32例小肠肿瘤的多层螺旋CT表现.结果 本组发生于十二指肠12例,空肠7例,回肠13例.13例腺癌、10例间质瘤、6例非霍奇金淋巴瘤及3例转移癌.结论 多层螺旋CT在小肠肿瘤诊断中的价值较大,尤其是增强扫描,大大提高了病灶的检出率,对常见小肠肿瘤的诊断与鉴别诊断具有较高的临床应用价值.     

胃肠道非霍奇金淋巴瘤多层螺旋CT诊断与临床分期的对比研究

目的：探讨多层螺旋CT对胃肠道非霍奇金氏淋巴瘤分期的价值。方法：对35例经手术或活检病理证实为胃肠道非霍奇金氏淋巴瘤多层螺旋CT资料进行分析,对其行螺旋CT分期并与术后临床病理分期进行比较。结果：本组病例对胃肠道非霍奇金氏淋巴瘤分期的符合率为83.0%（29/35）,其中Ⅰ期符合率为100.0%（8/8）,Ⅱ期符合率为70.1%（12/17）,Ⅲ期符合率为80.0%（4/5）,Ⅳ期符合率为100.0%（5/5）。结论：多层螺旋CT可全面评价胃肠道非霍奇金氏淋巴瘤的部位、侵犯程度、区域淋巴结及远处转移情况,对胃肠道非霍奇金氏淋巴瘤术前分期具有重要价值。     

腹股沟区多层螺旋CT解剖及其临床意义

目的 探讨腹股沟区多层螺旋CT解剖及其临床意义.资料与方法 回顾性分析30名正常人腹股沟区多层螺旋CT解剖和52例腹股沟区病变的CT表现,重点分析腹股沟区各关键解剖结构与腹股沟区病变的关系.结果 CT能较好地显示腹股沟管、腹股沟韧带、腹壁下动脉、精索或子宫圆韧带.显示率达100%,尤其是冠状位重组能直观地湿示腹股沟管的整体结构.CT斜冠状位重组更有利于认识股三角区.分析疝囊与腹股沟管、腹壁下动脉、耻骨结节及股静脉的关系有利于对腹股沟区疝的诊断.隐睾及精索病变位于腹股沟管内,腹膜后淋巴瘤、脓肿或结核、血肿以及髋关节病变多累及股三角区,转移淋巴结多位于腹股沟管和股血管周围.结论 多层螺旋CT能较好地显示腹股沟区的各种关键解剖结构,识别这些关键解剖有利于对腹股沟区病变的诊断和鉴别诊断.     

螺旋CT在小肠淋巴瘤诊治中的应用

目的:应用多层螺旋CT(MSCT)动态强化扫描对小肠淋巴瘤患者进行前瞻性研究,旨在提高多层螺旋CT在小肠淋巴瘤诊治中的价值。方法:通过对15例小肠淋巴瘤病人进行动态强化扫描,并对MSCT轴位图像和重建图像进行观察分析,分别对各病例进行诊断。结果:位于回肠11例,位于空肠3例,十二指肠的1例。15例患者CT均表现为肠壁不规则增厚,单发13例,其中表现为结节型5例、壁内浸润型的6例、息肉样肿块型2例。结论:多层螺旋CT动态强化扫描在小肠淋巴瘤的诊治中,具有独特的优越性。     

原发性胃淋巴瘤的多层螺旋CT诊断

目的 探讨原发性胃淋巴瘤的多层螺旋CT表现,提高对原发性胃淋巴瘤的认识及诊断水平.方法 回顾性分析经病理确诊的19例原发性胃淋巴瘤的CT影像特征.观察指标有病变部位、受累范围、胃壁厚度、强化程度、胃腔情况、黏膜及浆膜情况、胃周淋巴结及其他器官受累情况.结果 本组共19例原发性胃淋巴瘤,均为非霍奇金淋巴瘤.病变累及胃窦、体及底2个或3个部位16例,仅累及1个部位3例.所有病例均表现胃壁不均匀增厚(10～67 mm),其中弥漫性增厚9例,节段性增厚6例,局限性增厚4例.19例增厚胃壁均呈轻中度均匀强化.11例胃壁黏膜线完整,黏膜破坏8例.所有病例浆膜层光滑连续,周围脂肪间隙清晰.5例胃周淋巴结肿大.无1例肝脏、脾脏等脏器侵犯.结论 原发性胃淋巴瘤的CT表现具有一定的特征性,多层螺旋CT对其诊断和鉴别诊断具有很高的临床价值.     

多层螺旋CT在胆石性肠梗阻诊断中的价值

目的 探讨多层螺旋CT在胆石性肠梗阻诊断中的价值.方法 回顾分析15例经手术证实的胆石性肠梗阻病例的临床及影像资料.15例均行全腹部CT平扫、X线腹部平片和腹部超声检查.结果 多层螺旋CT显示肠梗阻共15例,不完全性小肠梗阻12例,完全性肠梗阻3例;异位结石15例,其中9例位于回肠,4例位于空肠, 1例于胆囊内及回肠内均可见结石,1例于胆囊-十二指肠瘘口及回肠内各见一结石;胆囊积气15例,胆道积气13例;胆囊窝结构紊乱15例,其中6例MPR图像清晰显示胆囊-十二指肠瘘.多层螺旋CT的诊断准确率可达100%.结论 多层螺旋CT在胆石性肠梗阻的定位和定性诊断中具有重要价值,为手术方案的制订提供影像学信息.     

The role of gallium 67 imaging in non-Hodgkin's lymphoma of the gastrointestinal tract

To evaluate the clinical usefulness of gallium 67 imaging in the detection of gastrointestinal (GI) non-Hodgkin's lymphoma (NHL) and in the assessment of the therapeutic effects, images were reviewed in 24 cases (25 lesions: stomach, 20; ileum, 2; and terminal ileum and or cecum, 3) and were compared using barium studies and, in 16 cases, computerized tomography (CT). In all, 23 (92.0%) of the 25 lesions were detected by 67Ga citrate imaging, the barium studies detected all 25, and CT detected 15 of 16 lesions (93.8%). The two lesions not identified by imaging and the one not found by CT were the smallest of all. In 2 (8.7%) of the 23 lesions positively identified by 67Ga-citrate imaging, both CT and imaging revealed the extent of the tumor more accurately than did the barium studies. In all but one of the patients, a close correlation existed between the imaging results and the therapeutic effects. These data suggest that 67Ga imaging is useful in conjunction with CT and barium studies for the detection of GI NHL and for the assessment of both the spatial extent of disease and the therapeutic effects, although a lack of 67Ga uptake after therapy does not always indicate a good therapeutic effect.     

The role of gallium 67 imaging in non-Hodgkin's lymphoma of the gastrointestinal tract

To evaluate the clinical usefulness of gallium 67 imaging in the detection of gastrointestinal (GI) non-Hodgkin's lymphoma (NHL) and in the assessment of the therapeutic effects, images were reviewed in 24 cases (25 lesions: stomach, 20; ileum, 2; and terminal ileum and/or cecum, 3) and were compared using barium studies and, in 16 cases, computerized tomography (CT). In all, 23 (92.0%) of the 25 lesions were detected by⁶⁷Ga citrate imaging, the barium studies detected all 25, and CT detected 15 of 16 lesions (93.8%). The two lesions not identified by imaging and the one not found by CT were the smallest of all. In 2 (8.7%) of the 23 lesions positively identified by⁶⁷Ga-citrate imaging, both CT and imaging revealed the extent of the tumor more accurately than did the barium studies. In all but one of the patients, a close correlation existed between the imaging results and the therapeutic effects. These data suggest that⁶⁷Ga imaging is useful in conjunction with CT and barium studies for the detection of GI NHL and for the assessment of both the spatial extent of disease and the therapeutic effects, although a lack of⁶⁷Ga uptake after therapy does not always indicate a good therapeutic effect.     

淋巴瘤累及小肠系膜的螺旋CT特征探讨

目的 探讨非霍奇金淋巴瘤(NHL)累及小肠系膜的多排螺旋CT表现特征. 资料与方法 回顾性分析22例经病理证实的NHL累及小肠系膜的CT表现. 结果 小肠系膜受累主要表现为系膜体部和系膜根部淋巴结受侵,小肠系膜局灶性密度增高13例.系膜体部淋巴结增大22例,其中增大淋巴结均匀强化者20例(90.9%),增大淋巴结有坏死者2例(9.1%).系膜根部淋巴结增大22例,其中增大淋巴结均匀强化者18例(81.8%),增大淋巴结有坏死者4例(18.2%).系膜体部"三明治征"6例,系膜根部"三明治征"12例. 结论 多排螺旋CT可全面显示NHL累及小肠系膜的解剖细节及淋巴结的病理改变.     

肺继发性淋巴瘤的CT多样性

目的：探讨肺继发性淋巴瘤的CT表现特征，以提高诊断正确率。材料和方法：回顾性分析临床或病理证实的26例肺继发淋巴瘤的CT征象，其中15例为非霍奇金淋巴瘤（NHL），11例为霍奇金病（HD）。本研究采用GE Hispeed CT／i，10例平扫，16例直接增强扫描。结果：CT表现多样：肺内毛玻璃样影（NHL 13vs HD6）；单发或多发肿块结节及肿块样实变（NHL 10vs HD8），其中仅HD组肿块中有4例病灶密度不均匀，5例见毛玻璃样晕症；黍粒样结节（NHL1）；支气管血管束增粗（NHL 1vs HD1）；肺门纵隔淋巴结肿大（NHL 9vs HD8）；胸膜侵犯（NHL 5vs HD2）；心包累及（NHL 2vs HD1）；常为多个征象合并出现（NHL 12vs HD5）。可分为以下四个类型：肺炎肺泡型（NHL 3vs HD1），肿块（结节）型（NHL 2vs HD2），黍粒型（NHL1），混合型（NHL 12vs HD5）。结论：多样性为肺继发性淋巴瘤的特点，不均匀的肿块或伴有病灶周围的毛玻璃样晕症多见于HD，对诊断可能有帮助。     

Multidetector-row computed tomography and 3-dimensional computed tomography imaging of small bowel neoplasms: current concept in diagnosis

The diagnosis of small bowel neoplasms can present a difficult challenge to the radiologist because the tumors are uncommon, often small, and may be difficult to detect radiographically. The most common small bowel neoplasms include adenocarcinoma, carcinoid, lymphoma, and gastrointestinal stromal tumors. The location and computed tomography (CT) appearance of the small bowel tumors may aid in the diagnosis. For instance, small bowel adenocarcinoma occurs more frequently in the duodenum and may result in obstruction. Carcinoid tumors are more common in the ileum and are typically hypervascular submucosal masses that produce a characteristic mesenteric mass when they spread to the mesenteric nodes. Lymphoma can occur anywhere along the gastrointestinal tract and have a variable CT appearance. It may appear as a single mass, multiple masses, an infiltrating lesion resulting in aneurysmal dilatation of the bowel, or as an exophytic mass. Gastrointestinal stromal tumors are more common in the jejunum and ileum and usually appear exophytic and bulky often with ulceration. Traditionally, small bowel series and enteroclysis have been used for imaging patients with suspected small bowel tumors. More recently, CT is beginning to play a more important role for this clinical indication. The thinner collimation possible with multidetector CT (MDCT) along with water as oral contrast and a good intravenous contrast bolus may improve the sensitivity of CT for detecting small bowel tumors. In addition, MDCT scanners improve the quality of the 3-dimensional CT (3D CT) images that are valuable to the clinicians and surgeons for surgical planning. It is important for the radiologist to be familiar with the CT appearance of these neoplasms and the potential role of MDCT and 3D imaging in their diagnosis and surgical planning.     

鼻腔非霍奇金淋巴瘤的CT诊断

目的 探讨鼻腔非霍奇金淋巴瘤(NHL)的CT表现特点及其临床应用价值。资料与方法回顾性分析经病理证实的18例NHL的CT表现。结果 18例NHL中，14例外周T细胞性淋巴瘤，4例NK/T细胞性淋巴瘤，CT表现：(1)16例病灶起源于鼻前庭或鼻前部。(2)3例呈结节状局限于鼻前庭；10例弥漫性浸润生长，其中包括3例多中心型；5例混合性病灶。(3)病变密度均匀，仅1例增强后弥漫性浸润病灶内出现小片状低密度区。(4)9例骨质无异常改变，6例骨质破坏不明显，以虫蚀样、虚线样骨质吸收为主；3例出现明显骨质缺损。(5)13例放化疗综合治疗后，l0例病灶完全消失，2例明显缩小，l例变化不明显，鼻窦炎症加重。结论 鼻腔NHL具有一定的CT影像特征，CT扫描能准确显示病变的侵犯范围和程度，为临床治疗提供可靠的依据。     

The role of gallium-67 citrate scintigraphy in gastro-intestinal malignant lymphoma

To evaluate the clinical usefulness of gallium-67 scintigraphy in the detection of the gastrointestinal (GI) non-Hodgkin's lymphoma (NHL) and in the assessment of the therapeutic effects, gallium-67 scintigraphy was reviewed on 24 cases (25 lesions; stomach in 20, ileum in 2, and terminal ileum and/or cecum in 3). Twenty-three out of the 25 lesions (92.0%) were detected by gallium-67 scintigraphy, while barium study could detect all of the 25 lesions. The sizes of the gallium-67 negative 2 lesions were the smallest of all (2.5 and 3.0 cm). The tumor size was considered to the most important factor in the detection by gallium-67 scintigraphy, while the histological classification and the location of the tumor were not related to its detectability. Findings in follow-up gallium-67 scintigraphy after therapy on 10 cases were correlated well with the therapeutic effects. These data suggest that gallium-67 scintigraphy is useful for the detection of GI involvement of NHL and for the assessment of therapeutic effects.     

口咽部恶性肿瘤的CT表现

目的　分析口咽部恶性肿瘤的CT表现 ,了解口咽癌及口咽淋巴瘤的诊断及鉴别诊断要点。资料与方法　回顾性分析经病理学证实的 70例口咽部恶性肿瘤的CT表现。其中口咽癌 4 5例 ,淋巴瘤 2 5例 ,对比分析口咽癌、淋巴瘤的范围、边界、密度变化 ,对其结果进行统计学分析。结果　 4 5例口咽癌 ,均为单侧病变 ,其中 4 1例有明确肿物 ,边界不清楚有外侵 32例 ;2 5例淋巴瘤中 ,9例为双侧病变 ,边界不清楚 12例 ,肿物边界之间有极显著性差异 (P <0 .0 1)。行增强扫描的口咽癌 37例 ,密度不均匀 2 7例 ,肿物无明显或轻度强化 12例 ,呈中度强化 17例 ,明显强化 8例 ;行增强扫描的淋巴瘤 19例 ,其中内部密度均匀 12例 ,不均匀 7例 ,肿物无明显或轻度强化 12例 ,中度强化 7例 ,经统计学处理二者密度均匀性有极显著性差异 (P <0 .0 1) ,肿物的强化程度之间有显著性差异 (P <0 .0 5 )。结论　口咽癌与口咽部淋巴瘤有不同的影像特点 ,肿物的范围、边界、密度变化及颈部淋巴结等特点为其诊断及鉴别诊断要点     

胃肠道黏膜相关淋巴组织淋巴瘤六例报告及文献复习

目的 报告6例胃肠道黏膜相关淋巴组织（mucosa-associated lymphoid tissue,MALT)淋巴瘤并结合文献探讨其影像学表现。方法 搜集经病理证实的胃肠道MALT淋巴瘤6例，其中来源于胃4例，十二指肠及回肠各1例，所有病例均经胃肠钡餐造影（GI）、CT或MRI检查。并复习了近几年国内外文献报道的胃肠道MALT淋巴瘤的临床及影像学表现。结果 根据该组病例临床及影像学所见，胃肠道MALT淋巴瘤临床及影像学特征为：（1）年龄在50岁以上，多为I－Ⅱ期低度恶性肿瘤，病程长，进展缓慢，症状轻，疗效好；（2）绝大多数幽门螺杆菌阳性，特别是胃MALT淋巴瘤；（3）GI示胃小区不规则增宽，多发性黏膜下小结节和多发边缘模糊的浅表溃疡，胃肠道黏膜皱襞粗大、紊乱迂曲，晚期呈多发息肉样结节、肿块及较大溃疡。CT及MRI表现为胃肠道壁环形光滑或小结节样增厚，肠MALT淋巴瘤可致肠腔狭窄。多发细小黏膜下病灶及多种征象共存是该病最重要的影像学特点。结论 典型影像学表现结合临床表现，可作出胃肠道MALT淋巴瘤的诊断。     

Detection and localization of acute upper and lower gastrointestinal (GI) bleeding with arterial phase multi-detector row helical CT

The purpose of this study was to evaluate the accuracy of multi-detector row helical CT (MDCT) for detection and localization of acute upper and lower gastrointestinal (GI) hemorrhage or intraperitoneal bleeding. Thirty-six consecutive patients with clinical signs of acute bleeding underwent biphasic (16- or 40-channel) MDCT. MDCT findings were correlated with endoscopy, angiography or surgery. Among the 36 patients evaluated, 26 were examined for GI bleeding and 10 for intraperitoneal hemorrhage. Confirmed sites of GI bleeding were the stomach (n = 5), duodenum (n = 5), small bowel (n = 6), large bowel (n = 8) and rectum (n = 2). The correct site of bleeding was identifiable on MDCT in 24/26 patients with GI bleeding. In 20 of these 24 patients, active CM extravasation was apparent during the exam. Among the ten patients with intraperitoneal hemorrhage, MDCT correctly identified the bleeding source in nine patients. Our findings suggest that fast and accurate localization of acute gastrointestinal and intraperitoneal bleeding is achievable on MDCT.