多层螺旋CT对原发性肾上腺淋巴瘤的诊断价值(附4例报告并文献复习).docVIP

多层螺旋CT对原发性肾上腺淋巴瘤的诊断价值 (附4例报告并文献复习) 曹代荣 吴小丽 刘颖 邢振 【摘要】 目的 探讨原发性肾上腺淋巴瘤的CT表现。 资料与方法 回顾性分析4例确诊为原发性肾上腺淋巴瘤患者的CT影像学资料。 结果 本组中双侧病灶3例，单侧病灶1例，共计7侧病灶；瘤体较大，长径5.6～7.8cm，平均6.3cm；边界清晰6例，边界不清1例；肾上腺明显增粗伴局部肿块4侧，肾上腺轮廓消失、呈不规则形3侧；CT平扫密度均匀6例，密度不均匀1例；行双期增强扫描，均匀强化5例，不均匀强化2例，其中1例病灶内见不规则无强化区。 结论 原发性肾上腺淋巴瘤的CT表现具有一定特征性，据此可提示诊断。 【关键词】原发性 肾上腺淋巴瘤 CT The Diagnostic Value of Multiple- detector Row CT in primary adrenal lymphoma :A Report of 4 Cases and Literature Review Cao Dairong,Wu Xiaoli,Liu Ying,Xing Zhen Department of Imaging，the First Affiliated Hospital of Fujian Medical University， Fuzhou，Fujian Province 350005，P．R．China 【Abstract】Objective To explore multiple-detector row CT findings of primary adrenal lymphoma. Materials and Methods The multiple-detector row CT image data of 4 cases with primary adrenal lymphoma proved by pathology was analyzed retrospectively. Results There were 7 lesions including 3 bilateral lesions and 1 unilateral lesions , maximum diameter of lesions was 5.6 cm～7.8 cm, with a mean diameter o f 6.3 cm. 6 lesions had clear margin and the other was poorly circumscribed. 4 lesions keeped adrenal shape and 3 lesions were showed as irregular mass. Most lesions presented as homogeneous density on noncontrasted CT and showed homogeneous enhancement with CT contrast. In 2 lesions of heterogeneous enhancement, one contained necrosis or cystic part without enhancement. Conclusion CT scan is useful for prompting primary adrenal lymphoma diagnosis . 【Key words】 primary adrenal lymphoma CT 肾上腺淋巴瘤分为原发性和继发性，原发性肾上腺淋巴瘤( primary adrenal lymphoma, PAL) 相对罕见。笔者搜集 2007年1月至2011年5月期间4例经组织病例证实的原发性肾上腺淋巴瘤患者的CT影像资料，通过分析其影像学特征并复习相关文献，探讨多层螺旋CT对原发性肾上腺淋巴瘤的诊断价值。 1 资料与方法 本组4例PAL中，男性3例，女性1例；年龄35～68岁，平均年龄53岁；1例为体检偶然发现，另3例分别因发热、中上腹部疼痛、左侧腰腿痛入院后检查发现；血浆乳酸脱氢酶升高2例；血浆促肾上腺皮质激素升高1例。 采用Toshiba16层Aquilion或Toshiba 320排Aquilion One多层螺旋CT扫描机，120 kV，200mA或350mA，0.5s /圈，矩阵512×512。患者取仰卧位，层厚和层间距均为3mm。4例均行CT平扫及增强扫描， 以肘前静脉为注射部位， 使用非离子型对比剂碘必乐(300 mgI /ml)，注射流率为3.5ml/s，剂量为1.5ml/kg。注射对比剂35 s～40s后行动脉期