MSCT低张肠道水造影成像在淋巴瘤诊断中的价值

目的：评价多层螺旋CT（MSCT）水造影成像在肠道淋巴瘤诊断中的价值。方法：采用口服甘露醇混合液充盈小肠，低张灌水充盈结肠，16层CT平扫及多期增强扫描，对增强扫描图像行回顾性重组，获得冠状面、矢状面或曲面重组图像，就肿瘤的部位、浸润范围、周围淋巴结及实质脏器侵犯等进行分析。结果：19例肠道淋巴瘤病理诊断均为非霍奇金氏淋巴瘤（mm），原发性16例，继发性3例；空肠1例，回肠9例，结肠9例；CT表现分为浸润增厚型（9例），息肉肿块型（6例），肠腔动脉瘤样扩张型（3例），肠系膜型（1例）。CT表现为病变肠管壁黏膜下层的不规则性增厚，黏膜面多示连续，浆膜层边缘较光整，肠管保持一定的柔软度和扩张度，病灶轻中度强化为主。定位、定性与术后病理诊断的符合率分别为100％、84．2％。结论：肠道淋巴瘤CT表现具有一定的特征性，MSCT低张肠道水造影成像能清楚显示肿瘤本身特征及周围组织关系，是肠道淋巴瘤术前诊断较理想的辅助检查方法。

The value of MSCT with hypotonic water contrast in diagnosing intestinal lymphoma

Objective： To study the value of MSCT with hypotonic water contrast in diagnosing intestinal lymphoma. Methods： Nineteen patients with intestinal lymphoma underwent abdominal MSCT after oral administration of mannitol mixture filling the small intestine and hypotonie water enema. Then, the coronal, sagittal or curved planar reconstruction image were obtained by images post-processing and analyzed according to the tumor sites, scope, lymphadenopathy, and involvement of other organs. Results： 19 cases by pathological diagnosis were non-Hodgldn lymphoma （NHL）, including 16 prirmary cases, 3 of secondary cases, involved the jejunum in one patients, the ileum in nine, the colon in nine cases. MSCT findings could be divided into four types： infiltration tifickening type （n= 9）, polypoid tumor type （n= 6）, aneurysmal-hke enteric cavity dilated （n= 3）, and mesenteric type （n= 1）. CT imagings showed lesions of intestinal submucosa wall of the irregular thickening with continuous mucosal surface and smooth serosal layer, intestine maintaining a certain degree of flexibility and expansion. The tumor was mildly or moderately enhanced after intravenous contrast agent. The rates of coincidence between CT findings and pathological diagnosis in location and quality were 100% and 84.2%, respectively. Conclusion：The cr manifestations of intestinal lymphoma has a certain characteristic. MSCT hypotonic intestinal water contrast imaging can clearly showed the characteristics of the tumor and surrounding tissue, which plays an important role in the preoperative diagnosis of intestinal lymphoma.