腹膜后淋巴结增大多层螺旋CT评价.docVIP

腹膜后淋巴结增大多层螺旋CT评价 　　【摘要】 目的 探讨腹膜后淋巴结增大的MSCT表现。方法 经临床和病理证实34 例纳入研究，其中淋巴瘤12例，转移瘤20例，巨淋巴结增生2例。结果 淋巴结转移主要分布腹主动脉上区,增强后均匀或环状强化多见。淋巴瘤主要分布于腹主动脉上、下区,增强后均匀强化多见。巨淋巴结增生增强后明显不均匀强化。结论 MSCT增强扫描可对腹膜后淋巴结增大进行鉴别诊断，为临床治疗提供帮助。? 　　【关键词】腹膜后;淋巴结;多层螺旋CT 　　 　　The evaluation ofenlarged retroperitoneal lymph nodes with multislice helical computed tomography(MSCT) 　　 　　ZHAO Hong,ZHANG Cuj-yun,WANG Yan,et al.Department of Radiology,Affiliated Fifth Hospital,Sun Yat-sen University,Zhuhai,519000,China 　　? 　　【Abstract】 Objective To evaluate the clinical significance of retroperitoneal lymphnodes scanned with MSCT.Methods Enlarged retroperitoneal lymphnodes were observed in 34 patients.The diagnosis in all cases was confirmed by clinical and pathology.12 cases Lymphoma,20 cases Lymphnode metastases,2 cases castleman disease.Results Lymphnode metastases commonly involved the lymph nodes in upperpara-aortic region,lymphoma commonly involved the lymph nodes in upperpara and inferpara-aortic region,rim enhancement or inhomogenous of the affected lymph nodes was seen in Lymphnode metastases.Lymphoma showed homogeneous enhancement,and castleman disease displayed strong inhomogeneous enhancement.Conclusion MSCT contrast enhancement is very useful in differential diagnosis of the enlarged retroperitoneal lymphnodes,and helps the clinical therapy.? 　　【Key words】Retroperitoneal;Lymph nodes;Multislice helical computed tomography 　　 　　腹部淋巴结病变主要包括肿瘤转移、淋巴瘤及巨淋巴结增生、结核等引起淋巴结增大。上腹部MSCT增强的扫描有助于显示腹膜后淋巴结肿大情况,还可区分淋巴结与腹膜后小血管影，同时可为临床治疗提供一定信息以及疗效观察。本文旨在分析总结腹膜后淋巴结增大的CT表现,以提高对本病的诊断与鉴别诊断水平。 　　 　　1 资料与方法? 　　 　　回顾分析近两年间住院病例中经MSCT增强检查腹膜后淋巴增大52例患者，男32例,女20例，年龄32~67岁,平均50．5岁。52例腹膜后淋巴结肿大中，经临床和病理证实34 例纳入研究，其中淋巴瘤12例，非霍奇金淋巴瘤10，非霍奇金淋巴瘤2例；转移瘤20例，肝癌4例;胰头癌2例，胆囊癌1例，肝门区胆管癌2例、胃癌4例、胃癌术后伴腹膜后淋巴结转移2例;食管癌术后、转移性肿瘤引起腹膜后淋巴结肿大各2例，肺转移癌1例；巨淋巴增生2例。? 　　全部病例均采用 Siemens Somatom Sensation 16层螺旋CT扫描机，周期0．5 s，准直器宽度1．5 mm，间隔8 mm，重建间隔8 mm，电压120 kV，电流128 mA。常规腹部CT平扫自膈顶上方2 cm至肾下极下方2 cm。增强扫描所用对比剂为非离子型对比剂(欧乃派克300 mg I/ml)，使用高压注射器注射，注射速率3 ml/s，增强扫描的延迟