腹部局限型Castleman病的CT及MRI表现

目的：探讨腹部局限型Castleman病的CT、MRI影像特点,以提高对该病的认识。方法回顾性分析2015年1月—2016年1月进入该院的7例经手术、病理证实的局限型腹部Castleman病的影像学资料,6例采用CT平扫及动态增强扫描方式,其中4例病例采用MRI平扫及动态增强扫描方式,仅1例采用MRI平扫及动态增强扫描。结果7例病理类型均为透明血管型,4例位于肠系膜,3例位于腹膜后。 CT平扫表现为单发的类圆形或椭圆形软组织肿块,在增强扫描可见动脉期显著强化,而门静脉期及延迟期呈现出持续强化,表现出来的强化方式与大血管相似,其中4例病灶周边可见增粗的血管影,2例动脉期病灶内可见裂隙状低密度区,门静脉期及延迟扫描低密度区逐渐缩小；采用MRI检查方式共检查5例病例,均为T1WI低信号、T2WI高信号,在增强扫描方面与CT有一定的相似性。结论临床中关于局限型Castleman病比较少见,但是影像学上具有比较明显的特征性表现,能够避免误诊的发生。

CT and MRI Findings of Local Castleman Diseasein the Abdomen

Objective To analyze the CT and MRI features of local Castleman disease of the abdomen,and toimprove the recognition of this disease. Methods A retrospective analysis of January 2015 to January 2016 in 7 cases in our hospital by surgery and pathology of the limitations of abdominal Castleman's disease image data, 6 cases by CT plain scanning and dy-namic enhanced scanning, among them 4 cases with MRI plain scanning and dynamic enhanced scanning mode, only 1 case mining with MRI plain scan and dynamic enhanced scans.Results The pathologic subtype of 7 cases of local Castleman disease was all hyaline vascular type,of which 4 hadmesentery, 3 had retroperitoneal. On CT scan, all the 5 cases with local-ized lesions showed single,round or ellipsesoft tissue masses,enhanced scanning revealed obvious enhancement in the arteri-al phase and continuousenhancement in the portal vein and delayed phase in all the lesions, with an attenuation pattern similar to that oflarge vessels;enlarged blood vesselswithin or around the mass were displayed in 4 cases. In 5 cases, the fis-sured non-enhanced areas in early stage of enhancement were gradually filled up as the scan timewas delayed. The patient receiving MRI showed hypo-intensity on T1WI and hyper-intensity on T2WI, presenting withan enhancement feature simi-lar to that of CT. Conclusion Local Castleman disease of the abdomen is rare, but its characteristic imaging features can help in the diagnosis and differential diagnosis.