彩色多普勒超声诊断恶性淋巴瘤结外浸润的价值

目的：探讨彩色多普勒超声对恶性淋巴瘤结外浸润的诊断价值。方法：回顾性分析1995年以来经超声引导穿刺活检病理证实的结内恶性淋巴瘤结外浸润58例的二维及彩色多普勒超声表现及特征，33例同期进行了CT检查。结果：结内恶性淋巴瘤结外最易受侵的脏器为脾脏，其次是肝脏、肾脏及睾丸等。本组脾脏浸润42例，占72.41％；肝脏受侵14例，占24.14％；肾脏受侵5例，占8.62％。声像图主要特征为受累脏器弥漫或局限分布的低回声结节和血流信号的增多。依据声像图特点，可分为两型四种声像图表现。本组Ⅰ型12例；Ⅱ型46例。结论：彩色多普勒超声对结内恶性淋巴结外浸润的检查无创无痛、方便快捷、结果可靠，可作为本病首选的影像检查方法。     

原发性肺结外NK/T细胞淋巴瘤的CT表现

目的 探讨原发性肺结外NK/T细胞淋巴瘤(ENKTCL)的CT表现,提高影像诊断的准确性.方法 回顾性分析经病理证实的5例原发性肺ENKTCL的CT征象.5例患者均行胸部CT检查,分析病变部位、数目、分布、形态、大小、密度、边界、病变内部情况、强化特点、纵隔及肺门淋巴结肿大、胸腔积液等.结果 5例患者肺部病变均为双侧多...     

非霍奇金淋巴瘤结外侵犯的影像学表现

目的：探讨非霍奇金淋巴瘤在淋巴结以外多系统侵犯的影像学特征。资料与方法：回顾性分析16例经手术病理或穿刺活检证实的非霍奇金淋巴瘤的临床和影像学资料，并复习相关文献。结果：16例非霍奇金淋巴瘤中，侵犯骨骼系统4例，分别累及髂骨、股骨、肱骨和脊柱，其中溶骨性破坏3例，混合性改变1例。侵犯软组织1例，MRI表现为等T1、长T2信号的巨大肿块，增强后明显强化。肝脏侵犯1例，CT表现为边界清楚的巨大肿块，伴有出血、坏死等不典型的肝肿瘤征象。脑室侵犯3例，CT表现为脑室壁有多个稍高密度结节影，增强后结节均匀强化，周围的脑白质有水肿改变。鼻腔及鼻窦侵犯3例，CT表现为鼻腔及鼻窦内软组织肿块和相对较轻的骨质破坏。侵犯胸部3例，表现为纵隔、肺门区肿块影，增强扫描不强化。1例肠系膜侵犯表现为边界清楚的不规则软组织肿块。结论：非霍奇金淋巴瘤结外多系统侵犯因其侵犯部位和生长方式的不同而具有相对特异的影像学表现，结合临床和相关资料，可使其诊断准确率提高，从而为临床治疗提供可靠的依据。     

全身多部位结外非霍奇金淋巴瘤多模态显像1例

患者男,18岁.主因“恶心呕吐1月,头晕头痛5天”于2017年3月21日就诊我院.患者就诊前1月餐后出现恶心呕吐症状,服药后症状好转,未予重视,5天前患者出现头晕头痛症状,呈持续性,并伴有低热,1月内体重减轻15 kg.     

胸部淋巴瘤的CT诊断

目的：复习胸部淋巴瘤的ＣＴ扫描和同期Ｘ线片，观察ＣＴ扫描对光部淋巴瘤的诊断分期及随诊价值。材料与方法分析２６例病理证实的淋巴瘤的ＣＴ所风，着重观察病变训位，对纵膈周围结构的侵犯，胸膜受累及纵膈外淋巴结及肺受侵情况。２６例中Ｈｏｄｇｋｉｎ病６例。非Ｈｏｄｇｋｉｎ淋巴瘤２０例。结果：２６例胸部淋巴瘤ＣＴ均显示为纵膈淋巴结肿大，前纵膈和气管旁组最常见２１例；气管与支气管组和隆突下组９例，腑部淋巴结４例；     

肾上腺淋巴瘤的CT诊断

肾上腺淋巴瘤少见 ,国内报道较少 ,且多为临床病理方面的报道[1～ 6] 。笔者搜集 6例肾上腺淋巴瘤报告如下。1　资料与方法本组 6例 ,男 5例 ,女 1例。年龄 35～ 78岁 ,平均 5 7岁 ,其中 5 5岁以上者 4例。伴有低热病史 (体温波动于 37℃～39℃之间 )者 4例 ,腹部隐痛者 3例 ,腰酸伴上腹部饱胀不适者 1例 ;1例以腹壁软组织结节就诊 ,1例因下腔静脉血栓形成出现下肢肿胀。 6例中 ,2例经手术证实 ,4例经穿刺活检证实。使用ＧＥＨｉｓｐｅｅｄＡｄｖａｎｔａｇｅ和Ｐｉｃｋｅｒ 12 0 0ＣＴ扫描仪 ,6例图 1、2　右侧肾上腺淋巴瘤。图 1:平扫示右…     

鼻腔淋巴瘤的CT诊断

目的：探讨原发鼻腔淋巴瘤的CT诊断。材料和方法：回顾性分析34例鼻腔淋巴瘤的CT表现,对肿瘤范围、密度、形态边缘和骨质情况进行分析。结果：肿瘤侵犯外鼻及鼻旁皮下20例、上颌窦17例、筛窦16例、鼻咽12例、眼眶10例、蝶窦7例、额窦4例、对侧鼻腔5例,个别病例侵犯颞下窝、颅前窝、颞窝、上腭和眶下裂。肿瘤分期：一期6例,二期10例,三期16例,四期2例。大多数病例病灶呈弥漫浸润状,边缘不清楚,密度均匀23例,稍不均匀11例,多数呈轻度强化。22例伴有骨质吸收破坏,12例无骨质异常。结论：鼻腔T细胞型淋巴瘤的CT表现具有一定特征,CT对其诊断具有较大的价值。     

结外淋巴瘤:影像学共性特征与病理的关系

目的 分析结外淋巴瘤的影像学特征,探讨影像学对其诊断价值.资料与方法 回顾性分析57例经手术病理证实的结外淋巴瘤病例,非霍奇金病54例,霍奇金病3例,初诊时均无明确淋巴瘤病史,术前分别经常规X线、CT和MRI检查.结果 57例结外淋巴瘤中,消化道14例,骨骼9例,脑7例,肾5例,肺4例,脾4例,肾上腺4例,肝脏3例,肌肉3例,胰腺2例,睾丸1例,阴道1例.常规X线检查22例,术前诊断6例;CT检查39例,术前诊断17例;MRI检查19例,术前诊断12例.CT检查47个病灶中,41个病灶密度均匀,6个病灶有程度不等坏死.MRI检查26个病灶中,T1WI为低或等信号,25个病灶T2WI为低、等或略高信号,1个病灶为高信号;17个病灶信号均匀,9个病灶信号不均匀.动态CT和MR增强47例,除脑淋巴瘤为进行性显著持续强化外,其他部位淋巴瘤为进行性轻到中度延迟强化.结外淋巴瘤瘤内常可见脏器原有解剖结构,如血管、支气管、肾盂、肌间隙等残留.结论 结外淋巴瘤共性表现包括肿瘤密实,瘤内可见原有解剖结构残留,MR T2WI多为等或略高信号;一般轻度至中度延迟强化.掌握结外淋巴瘤的一些特征性影像学表现,有利于提高诊断准确率.     

肾淋巴瘤的CT诊断

目的 探讨CT对肾淋巴瘤的诊断价值。材料与方法 回顾性分析6例经病理证实的肾淋巴瘤的CT表现。结果 肾淋巴瘤的CT表现可分为多发肿物型、弥漫增大型和肾周肿物型。结论 肾淋巴瘤常是全身性淋巴瘤的一部分,其CT表现常与其他实质性脏器一致。     

老年原发性结外非霍奇金淋巴瘤误诊1例

恶性淋巴瘤（malignant lymphoma,ML）是一组起源于淋巴组织的恶性疾病,分为非霍奇金淋巴瘤（NHL）和霍奇金淋巴瘤（HL）两大类。NHL的发病率是HL的6倍,而且NHL的高峰发病年龄是在老年。老年患者因基础疾病较多,当淋巴瘤起病于结外淋巴组织时,临床误诊、漏诊率多较高。我科1例老年患者误诊时间长达6年。现报告如下。     

Imaging of abdominal lymphoma

This article discusses the radiologic appearances of solid organ involvement with Hodgkin and non-Hodgkin lymphoma in the abdominopelvic region. The most common radiologic patterns of involvement are illustrated. The imaging characteristics of lymphomatous involvement of abdominal organs overlap with several other disorders and the specific features pertaining to lymphoma are highlighted. In patients who have known lymphomas, other important management considerations, such as staging, response to therapy, malignant transformation, and identification of recurrent disease, are also discussed. The emerging role of fluorodeoxyglucose positron emission tomography is briefly outlined.     

PET/CT在结外NK/T细胞淋巴瘤诊治中的应用进展

结外自然杀伤/T细胞淋巴瘤（ENKTL）是一种与EB病毒感染相关的非霍奇金淋巴瘤亚型,其侵袭性强,预后不良。准确的诊断和分期、及时的疗效及预后评估对患者治疗策略的制定至关重要。随着18F-FDG PET/CT在淋巴瘤中的广泛应用,其在ENKTL中的价值也越来越受到重视,笔者对PET/CT在ENKTL诊治中的应用进展进行综述。     

儿童腹腔非霍奇金淋巴瘤的CT表现

目的 探讨儿童腹腔非霍奇金淋巴瘤的CT诊断价值。方法 回顾性分析14例经病理证实的儿童腹腔非霍奇金淋巴瘤的CT表现。其中男8例，女6例，年龄3～14岁。10例经手术、4例经穿刺活检病理证实。结果 儿童腹腔非霍奇金淋巴瘤CT征象为：(1)腹腔多发、巨大、不规则形肿块(14例)；(2)肠壁增厚(6例)；(3)肠系膜淋巴结肿大融合、伴腹膜后淋巴结增大，包绕肠系膜血管和腹腔干，形成所谓的“三明治征”(6例)；(4)肠管动脉瘤样扩张(4例)；(5)肠腔内可见气．液平面(2例)；(6)浸润邻近器官，其中脾脏1例、肾脏1例、肝脏1例；(7)引起不完全性肠梗阻(1例)；(8)增强扫描肿瘤实质中度强化(13例)；(9)合并腹水(4例)。结论 CT检查对儿童腹腔淋巴瘤的诊断以及明确病灶范围具有重要的价值。     

The role of F-18 positron emission tomography/computed tomography in evaluation of extranodal lymphoma

Aim and objectives

To assess the added value of hybrid FDG PET/CT in evaluation of extranodal lymphoma.

CT in the diagnosis of abdominal wall hernias: a preliminary study

The aim of the study was to estimate the value of CT in the diagnosis of abdominal wall hernias and at the same time to create a standard for this CT investigation. Twenty-four patients with suspected hernia of the abdominal wall were examined. All were operated on. The CT scans were assessed by two radiologists to estimate the interobserver variation. The CT diagnoses made by the two radiologists were correct in 83 % and 79 % of cases, respectively. The sensitivity was 0.83 in both CT evaluations and the specificity was 0.83 and 0.67, respectively. The predictive value of a positive CT finding was 0.94 and 0.88, while the predictive value of a negative CT finding was 0.63 and 0.57, respectively. The interobserver variation (kappa) was 0.87. The study therefore indicates that a positive CT finding of abdominal wall hernia is reliable, while a negative finding does not exclude the diagnosis. The interobserver variation of the CT diagnoses is acceptable. To achieve the highest diagnostic accuracy, it is recommended to always use the Valsalva manoeuvre, oral intake of contrast and 10/10 mm CT slices. Received: 19 November 1996; Revision received 17 February 1997; Accepted 17 March 1997     

Optimal abdominal CT protocol for obese patients

IntroductionThis study investigated the impact of different protocols on radiation dose and image quality for obese patients undergoing abdominal CT examinations.MethodsFive abdominal/pelvis CT protocols employed across three scanners from a single manufacturer in a single centre used a variety of parameters (kV: 100/120, reference mAs: 150/190/218/250/300, image reconstruction: filtered back projection (FBP)/iterative (IR)). The routine protocol employed 300 reference mAs and 120 kV. Data sets resulting from obese patient examinations (n = 42) were assessed for image quality using visual grading analysis by three experienced radiologists. Objective assessment (noise, signal/contrast-noise ratios) and radiation dose was compared to determine optimal protocols for prospective testing on a further sample of patients (n = 47) for scanners using FBP and IR techniques.ResultsCompared to the routine protocol, mean radiation dose was reduced by 60% when using 100 kV and SAFIRE technique strength 3 (p = 0.001). Reduction of up to 30% in radiation dose was noted for the FBP protocol: 120 kV and 190 reference mAs (p = 0.008). Subjective and objective image quality for both protocols were comparable to that of the routine protocol (p > 0.05). An overall improvement in image quality with increasing strength of SAFIRE was noted. Upon clinical implementation of the optimal dose protocols, local radiology consensus deemed image quality to be acceptable for the participating obese patient cohort.ConclusionRadiation dose for obese patients can be optimised whilst maintaining image quality. Where iterative reconstruction is available relatively low kV and quality reference mAs are also viable for imaging obese patients at 30–60% lower radiation doses.     

CT of hemodynamically unstable abdominal trauma

This article is an appraisal of the use of CT in the management of patients with unstable abdominal trauma. We examined 41 patients with abdominal trauma using noncontrast dynamic CT. In 17 patients a postcontrast dynamic CT was also carried out. On CT, 25 patients had hemoperitoneum. Thirteen patients had splenic, 12 hepatic, 6 pancreatic, 8 bowel and mesenteric, 12 renal and 2 vascular injuries. Seven patients had retroperitoneal and 2 patients adrenal hematomas. All but five lesions (three renal, one pancreatic, and one splenic) were hypodense when CT was performed earlier than 8 h following the injury. Postcontrast studies (n = 17), revealed 4 splenic, 3 hepatic, 1 pancreatic, 3 renal, and 2 bowel and mesenteric injuries beyond what was found on noncontrast CT. Surgical confirmation (n = 21) was obtained in 81.81 % of splenic, 66.66 % of hepatic, 83.33 % of pancreatic, 100 % of renal, 100 % of retroperitoneal, and 85.71 % of bowel and mesenteric injuries. The majority of false diagnoses was obtained with noncontrast studies. Computed tomography is a remarkable method for evaluation and management of patients with hemodynamically unstable abdominal trauma, but only if it is revealed in the emergency room. Contrast injection, when it could be done, revealed lesions that were not suspected on initial plain scans. Received: 13 March 1997; Revision received: 1 December 1997; Accepted: 6 May 1998     

小肠原发性恶性淋巴瘤的CT诊断

目的 探讨原发性小肠恶性淋巴瘤的CT诊断价值。方法 11例均行CT平扫,8例加做增强扫描,扫描层厚、层距均为10mm。结果 11例肿瘤,发病部位以回肠最常见,占10例。肠壁环形增厚型7例,其中5例见肠腔呈动脉瘤样扩张;肠腔内息肉样肿块型4例,3例继发肠套叠。该2型同时伴有肠系膜淋巴结多发肿在7例,其中1例见“夹心面包征”;受累肠段显著较长或呈多发节段性分布4例。CT初诊肿瘤检出9例,定性诊断准确7例。结论 肠壁增厚型和肠腔内息肉样肿块型是小肠原发性淋巴瘤的2种主要CT表现类型,伴有肠系膜淋巴结多发肿大的肠壁增厚或肠腔内分叶状肿块、“动脉瘤样肠腔扩张征”、“夹心面包征”、受累肠段较长及呈多发节段性分布是小肠原发性淋巴瘤的主要特征性CT表现,具有较可靠的定性诊断价值。     

小儿腹部Burkitt淋巴瘤结外侵犯的MSCT表现

目的：探讨儿童腹部Burkitt淋巴瘤结外侵犯的MSCT表现及其诊断价值。方法：回顾性分析本院22例经病理证实的Burkitt淋巴瘤的腹部MSCT资料,对其结外病变进行分类和影像学表现分析。结果：Burkitt淋巴瘤可侵犯腹盆腔的多个结外脏器,包括腹部实质脏器（8/22）和胃肠道（21/22）。病变多表现为轻度强化的密度均匀的实性肿物,出血、坏死少见,钙化罕见;常伴肠系膜及腹膜后多个肿大淋巴结、大网膜广泛增厚或腹腔积液,以回肠远端浸润型和胰腺多发结节型最多见。结论：Burkitt淋巴瘤常同时侵犯腹盆腔多个结外脏器,儿童Burkitt淋巴瘤腹部结外侵犯的MSCT表现有一定特征性。