眼眶原发性淋巴瘤的MRI表现

目的：探讨眼眶原发性淋巴瘤的磁共振影像学表现,以提高其诊断的准确率。方法对11例经手术病理证实的原发性淋巴瘤的临床和影像学资料进行回顾性分析。结果眼眶原发性淋巴瘤的MRI特征如下：①好发于隔前眶周,以眼眶外上象限为主,包括眼睑、泪腺、结膜等;②无包膜,沿眼眶间隙蔓延塑形生长;③平扫T1WI呈等信号,T2WI呈稍高信号,增强呈中-重度强化;④DWI上表现为高信号;⑤边界较清晰,对周围组织结构侵犯、破坏少见;⑥囊变少见,出血、钙化罕见。结论眼眶原发性淋巴瘤MRI表现具有一定的特征性,MRI多方位成像可对肿瘤明确定位,并有助于定性诊断。     

眼眶分区及CT、MRI征象在眼眶占位性病变中的诊断价值

目的 探讨眼眶分区及CT、MRI征象在鉴别眼眶良、恶性占位性病变的诊断价值.方法 收集201例经病理证实的眼眶占位性病变临床及CT、MRI资料,按4分区法统计分析病变在眼眶各区的分布情况及病变部位、形态、边界、与周围结构关系、MRI信号、CT密度、钙化、眶壁骨质改变等指标在鉴别眼眶良、恶性占位的诊断价值.结果 (1)病变分布:①眼眶良、恶性占位性病变总体在各区的分布差异有统计学意义(χ2总=48.93,P=0.000).病变仅位于骨膜外区18例、神经鞘区4例、肌锥内区39例均为良性.肌锥外区病变103例,良性(64%,66/103)多于恶性(36%,37/103).②眼眶良、恶性占位性病变在单区及混合区的分布差异有统计学意义(χ2=25.559,P=0.000).164例单区病变,良性(77%,127/164)多于恶性(23%,37/164);37例混合区病变,恶性(65%,24/37)多于良性(35%,13/37).(2)CT、MRI征象:201例病变,140例良性,61例恶性,其中(良性/恶性):形态规则(93/10),边界清楚(108/24),包绕眼球(24/39),骨质破坏(4/11).病变形态、边界、包绕眼球、骨质破坏在眼眶良、恶性病变之间有差异.钙化、T1WI/T2WI信号、眼球变形移位及是否单双侧发病在眼眶良、恶性病变中无差异.结论 眼眶占位性病变在眼眶各区的分布及其CT、MRI征象有一定规律, 根据眼眶分区及征象特点有助于诊断.     

常规及功能MR在眼眶原发黏膜相关淋巴组织淋巴瘤中的诊断价值

目的：探讨常规和功能磁共振(MR)对眼眶原发黏膜相关淋巴组织淋巴瘤(MALToma)的综合诊断价值。方法收集本院经手术病理证实的22例眼眶原发 MLAToma 患者的 MR 资料。MR 扫描序列包括常规 MR、扩散加权成像(DWI)和 MR 动态增强成像(DCE-MRI)。在常规 MR 图像上主要观察病灶的数目、位置、形态、对眶周结构的侵犯和常规 MR 图像信号特征。在功能MR 图像上主要测量病灶的表观扩散系数(ADC)和观察 DCE-MRI 时间-信号强度曲线(TIC)类型。结果22例中,单侧受累17例,双侧受累5例。其中眼前区域受累最为常见(20例),随后依次为肌锥内区(19例)、肌锥外区(17例)和泪腺区(12例)。与眼外肌信号比较,病灶在 T1 WI 上20例呈等信号,2例呈低信号,信号均匀。在 T2 WI 上20例呈等信号,2例呈低信号,其中19例信号均匀,3例信号不均匀。22例眼眶原发 MALToma 的平均 ADC(ADCM )值为(0.61±0.08)×10-3 mm2/s。15例动态增强时 TIC呈速升速降型,7例呈平台型。结论常规 MR 能准确地反映病灶的眶内位置及邻近结构的累及情况,功能 MR 能定量反映肿瘤的组织学特征。两者结合能提高术前定性诊断率。     

原发性肾上腺淋巴瘤的CT、MRI表现特征

目的探讨CT和MRI对原发肾上腺淋巴瘤的诊断及鉴别诊断价值。方法对4例经病理证实的原发肾上腺淋巴瘤的CT、MRI表现进行回顾性分析,其中2例同时行MR和CT检查,2例仅行CT检查,观察肿瘤的CT和MRI表现。结果双侧3例,单侧1例,共7个肿瘤。肿瘤最大径5.0¹3.0 cm。肿瘤呈圆形或椭圆形4个,三角形1个,不规则形2个;边界清晰5个,边界不清2个。CT平扫肿瘤类似于肌肉的密度,6个肿瘤密度均匀,1个欠均匀;MRI平扫T1WI肿瘤呈等或稍低信号,T2WI呈中等信号;增强后肿瘤呈轻至中度均匀或稍不均匀强化;3个肿瘤累及同侧肾脏和血管,表现为肿瘤包绕肾上极、肾门或相邻的血管。结论原发性肾上腺淋巴瘤的CT和MRI表现具有一定特征性。     

眼眶淋巴瘤CT和MRI诊断分析

目的分析眼眶恶性淋巴瘤的CT和MBI表现特点,以提高对本病的诊断和鉴别诊断水平。资料与方法回顾性分析70例病理证实的眼眶恶性淋巴瘤的临床和影像资料,70例均做CT检查,9例加做MBI检查,分析肿瘤部位、密度、信号、形态和骨质等表现。结果男女之比4：1,中位年龄57岁,68例（97％）为B细胞型淋巴瘤,5例（7％）伴有身体其他部位淋巴瘤。双侧眼眶发病19例（27％）,共计70例／89眶。影像学表现：（1）侵犯部位：肿瘤弥漫侵犯眼球前后和肌锥内外间隙18例／24眶,球后20例／24眶（肌锥内间隙为主14例／16眶,肌锥外间隙为主6例／8眶）;局限于眼睑7例／9眶,结膜4例／5眶,泪腺区11例／14眶,泪囊区5例／5眶,眼外肌3例／6眶,眼眶鼻侧和筛窦2例／2眶。（2）密度和信号：多数肿瘤CT平扫和增强扫描密度均匀（分别为87％和81％）,48例（90％）呈中度或明显强化。多数肿瘤（8／9）在T1WI和T2阳上呈中等、均匀信号,与脑灰质相仿,T2信号略高于T1,强化均匀。（3）形态边缘：肿瘤形态多不规则,边缘呈浸润状,沿眼球壁、泪腺、视神经、眼外肌、眶隔或眶壁蔓延生长。（4）眶骨：66例（94％）无骨质改变。结论眼眶恶性淋巴瘤的CT和MRI表现具有一些特征,影像学检查对本病的诊断具有重要价值,但部分病例与炎性假瘤和良性淋巴组织增生性病变鉴别较困难。     

眼眶黏膜相关淋巴组织淋巴瘤的影像及临床病理分析

目的：探讨眼眶黏膜相关淋巴组织（MALT）淋巴瘤的影像特征及病理特点,以提高术前诊断准确率。方法：回顾性分析9例经术后病理证实的眼眶MALT淋巴瘤的CT、MRI表现及病理特点。重点观察病灶的位置、形态、密度/信号、对眶周结构的侵犯等影像征象。结果：9例（共16侧）,其中7例双侧受累,2例单侧受累,累及眶隔前区（68.8%,11/16）、泪腺区（75.0%,12/16）、肌锥外区（75.0%,12/16）、肌锥（37.5%,6/16）、肌锥内区（31.2%,5/16）、眼球区（12.5%,2/16）、视神经鞘区（6.2%,1/16）、骨膜下区（6.2%,1/16）。行CT扫描6例11侧中,呈等密度（8侧）或呈稍高密度（3侧）。6例12侧行MRI扫描中,T₁WI呈等信号（10侧）或呈稍低信号（2侧）,T₂WI呈等信号（5侧）或呈稍高信号（7侧）,增强扫描病灶轻中度强化。术后病灶HE染色显示9例（16侧）均为小B细胞来源,免疫组化结果显示病灶CD20+（16/16）、Bcl-2+（16/16）、CD79a+（14/16）、PAX-5+（13/16）。结论：眼眶MALT淋巴瘤多累及双侧,沿眼眶间隙铸型生长,肿块密度/信号均匀,对周围组织结构侵犯、骨质破坏少见,CT及MRI对疾病的术前定性诊断具有重要作用。     

女性生殖系统淋巴瘤CT及MRI表现

目的：探讨女性生殖系统淋巴瘤的计算机体层成像（computed tomography,CT）及磁共振成像（magnetic resonanceimaging,MRI）特征,以期提高治疗前的诊断准确度。方法：回顾并分析13例女性生殖系统淋巴瘤患者的CT及MRI资料,其中7例行MRI平扫+增强扫描,6例行CT平扫+增强扫描。结果：13例患者中,弥漫性大B细胞淋巴瘤12例（92.3%）,滤泡性淋巴瘤1例（7.7%）,其中以卵巢受累最多见（6/13,46.2%）,其次是宫颈（5/13,38.5%）和子宫体（2/13,15.4%）。共检查发现14个病灶（MRI和CT各7个）,其中1例卵巢淋巴瘤为双侧受累。所有病灶均为实性肿块,64.3%(9/14)的病灶信号或密度相对均质;35.7%(5/14)的病灶边缘可见小囊变区,均见于卵巢淋巴瘤。行CT扫描的7个肿块中,平扫均表现为等密度肿块,内部未见出血及钙化;行MRI扫描的7个肿块中,表现为T1加权成像（T1-weighted imaging,T1WI）等或稍低信号,T2加权成像（T2-weighted imaging,T2WI）以中等信号为主（6/7...     

原发性肺淋巴瘤的CT、临床及病理特征分析

目的 探讨原发性肺淋巴瘤(PPL)的CT表现、临床和病理特征.方法 回顾性分析经病理证实的27例PPL的临床、病理及CT资料,观察指标包括病灶的部位、数量、形态、边界、密度、强化程度、肿瘤与支气管、血管的关系等.结果 27例PPL中,11例无临床症状,11例有咳嗽、咳痰,少数表现为发热或胸痛.病理诊断为霍奇金淋巴瘤(H...     

眼眶淋巴瘤的MRI征象

目的探讨眼眶淋巴瘤的MRI特点,提高对本病的认识和术前诊断准确率。资料与方法回顾性分析8例经手术病理证实的眼眶淋巴瘤的MRI表现,包括病变部位、数量、形态、大小、MRI信号及对邻近结构的侵犯。结果 8例患者中,6例为单侧,2例为双侧。4例位于眼眶前部,包括眼睑、泪腺及眼球周围,1例位于肌锥外间隙,4例呈弥漫性,位于眼眶前部及肌锥内外间隙,并不同程度地包绕眼球;1例可见眼眶骨质破坏,并突破眶骨向颅内外蔓延;8例均未见囊变、坏死。6例平扫T1WI呈等信号,2例呈稍低信号;6例T2WI呈均匀稍高信号,2例呈等信号;增强扫描后6例呈与眼外肌信号一致的中度均匀强化,2例为轻度均匀强化。结论眼眶淋巴瘤的MRI表现有一定的特征性,好发于眶隔前部,并向眶内侵犯;单侧多见,也可以双侧多发;呈多形性、塑形性、浸润性生长,信号多均匀,增强扫描多呈轻中度强化,少见骨质破坏,掌握其MRI表现有助于术前定性诊断。     

原发性肾上腺淋巴瘤的影像学表现

目的 分析原发性肾上腺淋巴瘤(PAL)的影像学表现及特点,并与肾上腺其他常见肿瘤鉴别.方法 回顾性分析7例经临床及病理证实的PAL;5例证实为弥漫大B细胞淋巴瘤(DLBCL),2例证实为外周T细胞淋巴瘤(PTCL);患者均行CT检查,观察其CT特点.结果 7例患者,共12个肿瘤;双侧肿瘤5例,单侧肿瘤2例,肿瘤直径范围4.4～14.2cm,中位数为6.5 cm;肿块型11个,类肾上腺型1个;平扫11个肿瘤呈低密度,1个呈等密度;增强后动脉期9个肿瘤为轻度强化,3个肿瘤为中度强化;门脉期12个肿瘤均为中度强化;其中有3个肿瘤强化不均,2个肿瘤境界不清,2个肿瘤累及周围结构,1例伴有腹膜后淋巴结肿大.结论 PAL好发双侧,影像表现为体积较大的软组织块影,密度较均匀,增强后为渐进性轻中度强化.     

胸腺原发黏膜相关淋巴组织淋巴瘤的CT诊断

目的探讨胸腺原发性黏膜相关淋巴组织淋巴瘤(MALToma)的CT表现和诊断价值。方法搜集本院经病理证实的胸腺原发MALToma 7例。观察胸腺MALToma的CT特征,并与6例胸腺癌及6例胸腺弥漫大B细胞淋巴瘤的CT表现进行对照。结果7例MALToma患者中男性2例,女性5例,年龄<40岁者5例(5/7),与胸腺癌(0/6)相比P<0.05),而与弥漫大B细胞淋巴瘤(6/6)比较无统计学差异;胸腺MALToma所有病灶均呈单侧生长(7/7),与弥漫大B细胞淋巴瘤(1/6)比较P<0.05,而与胸腺癌(5/6)比较无统计学意义;所有MALToma病灶均呈囊实性肿块(7/7),囊变区呈小而多发,囊与囊之间分界清楚,囊壁光滑,胸腺癌囊变多呈单个大片坏死(4/6),边缘欠清,弥漫大B细胞淋巴瘤囊变较少见(2/6,P<0.05);所有MALToma病灶均无纵隔淋巴结肿大(0/7),胸腺癌中2例出现淋巴结肿大(2/6),两者比较无统计学差异,而弥漫大B细胞淋巴瘤均有纵隔淋巴结肿大(6/6,P<0.05);所有MALToma病灶均未出现周围大血管侵犯(0/7),与弥漫大B细胞淋巴瘤(5/6)比较P<0.05,而与胸腺癌(2/6)比较无统计学差异。结论CT表现在胸腺原发性MALToma的诊断中具有一定价值。     

肺黏膜相关淋巴组织淋巴瘤的CT表现

目的探讨肺黏膜相关淋巴组织(MALT)淋巴瘤的CT表现,以提高对本病的认识。方法回顾性分析21例经手术、穿刺活检病理证实的肺黏膜相关淋巴组织淋巴瘤的CT影像表现。结果 21例MALT中,双侧肺分布14例(66.7%),单侧肺病灶7例(33.3%)。病灶形态呈斑片及实变影16例(76.2%),结节形或肿块样4例(19%),弥漫性间质性改变1例(4.8%)。结节状病灶、实变病灶及斑片状病灶内有较粗大的支气管充气征12例,粗大蜂窝状改变2例,MALT病灶边缘较清晰,不规则15例,伴毛刺样改变的5例,胸膜凹陷的3例,伴胸腔积液的4例。结论肺MALT淋巴瘤CT表现多样,可为单发结节影、斑片状影及实变影,亦可弥漫性间质性改变,病灶内常伴有粗大的支气管充气征,病灶周边不规则,伴毛刺及胸膜凹陷改变,上述影像表现要考虑MALT的诊断。     

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.     

Pulmonary mucosa-associated lymphoid tissue lymphoma: CT and pathologic findings

OBJECTIVE: The objective of this study was to determine the CT findings in pulmonary mucosa-associated lymphoid tissue lymphoma and to correlate these CT findings with histologic specimens. CONCLUSION: In the 11 patients reviewed, the most common CT appearance of pulmonary mucosa-associated lymphoid tissue lymphoma was consolidation with air bronchograms, correlating histologically with a cellular lymphocytic infiltrate expanding the interstitium and compressing adjacent alveoli, producing air bronchograms.     

CT appearances of mucosa-associated lymphoid tissue (MALT) lymphoma

Mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade lymphoma that differs from high-grade non-Hodgkin lymphoma both clinically and histologically. The CT appearances of MALT lymphoma are described. Of 40 patients referred with biopsy-proven MALT lymphoma, only seven had not had gastrectomy or chemotherapy prior to CT examination. The CT scans of these seven cases were analysed for the degree and extent of gastric wall thickening, enlargement of abdominal and extra-abdominal lymph nodes, and presence of extranodal disease. In all patients the stomach was distended with oral contrast medium and scans performed at narrow collimation, after intravenous administration of 20 mg hyoscine butylbromide. In six patients focal thickening of the gastric wall was 1 cm or less. One patient had thickening of over 4 cm. There was no enlargement of abdominal or extra-abdominal lymph nodes or extension to adjacent organs. Thus on CT, at presentation, MALT lymphoma results in minimal gastric wall thickening, unlike high-grade non-Hodgkin lymphoma, which typically causes bulky gastric disease, nodal enlargement and extension into adjacent organs. CT is therefore of limited value in monitoring response to treatment. With disease greater than minimal thickening, transformation to a higher grade should be considered. Received: 22 April 1998; Accepted: 27 October 1998     

Gastric mucosa-associated lymphoid tissue lymphoma: helical CT findings and pathologic correlation

OBJECTIVE: The purpose of this study was to describe helical CT findings of gastric mucosa-associated lymphoid tissue (MALT) lymphoma and to correlate them with pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed CT examinations of 58 patients with confirmed gastric MALT lymphomas. Using the histopathologic grade of the MALT lymphomas, we divided the patients into two groups: those with high-grade lymphoma (n = 21) and those with low-grade lymphoma (n = 37). Common CT findings for the two groups were reviewed and compared. RESULTS: Forty (69%) of the 58 patients showed at least one abnormality of the stomach on CT. Abnormalities included diffuse or segmental gastric wall thickening (66%, 38/58), lymphadenopathy (40%, 23/58), ulcer (22%, 13/58), and gastric mass (3%, 2/58). Eighteen (31%) of 58 patients were found to have no abnormality. The high-grade group had a higher incidence of abnormalities seen on CT than the low-grade group (100% vs 51%, respectively). Gastric wall thickening in the high-grade group was more diffuse (48% vs 8%) and severe (71% vs 14%; severe or moderate) than that seen in the low-grade group. Lymphadenopathy was visualized in 67% of the high-grade group and in 24% of the low-grade group. Gastric ulcer was found in 57% of the high-grade group and in only 5% of the low-grade group. The gastric mass formation was seen in only two patients in the high-grade group. CONCLUSION: The CT findings of gastric MALT lymphoma that the two groups had in common were gastric wall thickening and lymphadenopathy. Although our results pointed to no specific CT finding for differentiating high-grade from low-grade gastric MALT lymphomas, we found that the absence of abnormality on CT is highly predictive of low-grade MALT lymphoma.     

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.