结肠淋巴瘤与结肠癌CT征象对比分析

目的探讨结肠淋巴瘤与结肠癌的CT征象间的差异,以提高对两者鉴别的准确性。方法回顾性分析经手术病理或穿刺活检证实的结肠淋巴瘤11例及结肠癌13例的CT表现。所有病例均行CT平扫及增强扫描。运用Fisher精确检验的统计方法对两者肠壁增厚程度,CT增强扫描动脉期及静脉期强化程度、病灶周围淋巴结个数、周围最大淋巴结的短径、受累肠管的长度之间的差异进行比较分析。结果11例结肠淋巴瘤及13例结肠癌均有不同程度的管壁增厚及管腔狭窄;二者管壁增厚程度及CT强化程度的差异无统计学意义(P>0.05)。结肠淋巴瘤周围淋巴结个数较多于结肠癌,二者差异有统计学意义(P=0.001),11例结肠淋巴瘤中3例出现淋巴结的融合,13例结肠癌均未出现淋巴结融合,二者周围最大淋巴结的短径差异有统计学意义(P=0.015)。结肠淋巴瘤累及肠管的长度较长于结肠癌,二者累及肠管长度的差异有统计学意义(P=0.008)。结论CT能较准确地显示发病部位,肠管的浸润及与周围结构的关系,病灶周围淋巴结的个数、最大淋巴结的短径及受累肠管的长度对鉴别结肠淋巴瘤与结肠癌有帮助意义。

Comparative analysis of CT signs of colonic lymphoma and colon cancer

Objective To investigate the difference of CT signs between colonic lymphoma and colon cancer and to improve the accuracy of differential diagnosis.Methods CT findings of 11 cases of colonic lymphoma and 13 cases of colon cancer confirmed by surgical pathology or biopsy were retrospectively analyzed.All patients underwent CT plain scan and enhanced scan.Fisher's exact test was used to compare the degree of colonic wall thickening,CT enhancement in arterial and venous phases,the number of lymph nodes around lesions,the short diameter of the largest lymph nodes around,and the length of the diseased bowel.Results 11 cases of colonic lymphoma and 13 cases of colon cancer had varying degrees of wall thickening and luminal stenosis.There was no significant difference in the degree of wall thickening and CT enhancement between the two groups(P>0.05).The number of lymph nodes around the colonic lymphoma were more than those of colon cancer.The difference was statistically significant(P=0.001).Among the 11 cases of colon lymphoma,3 cases had lymph node fusion,and 13 cases of colon cancer were not.There was statistically significant difference in the short diameter of the largest lymph nodes around between two groups(P=0.015).The length of diseased bowel in colonic lymphoma was longer than that of colon cancer,and there was significant difference in the length of the intestine between the two disease(P=0.008).Conclusion CT can accurately display the lesion’s site,infiltration of colonic wall and its relationship with adjacent structures.The number of lymph nodes around the lesion and the short diameter of the largest lymph nodes are helpful for differentiating between colonic lymphoma and colon cancer.