肾上腺淋巴瘤:双期增强CT诊断价值

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目的探讨肾上腺淋巴瘤的CT表现特征及其双期增强的诊断价值。资料与方法回顾性分析经手术病理证实的B细胞型非霍奇金淋巴瘤8例,术前行CT平扫和双期增强检查。所有病例影像资料均经3名高年医师分析阅片,分别确定病变大小、形态、边缘、密度以及强化程度和类型。其中,2例同时作了MR检查。结果8例肾上腺淋巴瘤11个病灶中,双侧3例,单侧5例;病灶呈椭圆形8个,三角形3个。肿瘤直径4.1~10.7 cm,平均6.3 cm。10个病灶CT平扫密度相对均匀,1个病灶密度不均匀,所有病灶密度高于大多数肾上腺肿瘤,平扫CT值为24.1~35.2 HU,平均25.5 HU;双期增强动脉期病灶轻度强化,均匀强化4个病灶,不均匀强化7个病灶,动脉期CT值28.3~44.7 HU,平均31.6 HU;门静脉期中度强化,所有病灶强化趋于均匀,门静脉期CT值36.4~62.6HU,平均48.7 HU。结论肾上腺淋巴瘤密度相对均匀,密度高于大多数肾上腺肿瘤,坏死少见或范围较小,双期增强呈轻~中等程度进行性延迟强化,强化较均匀。 Objective To investigate the CT features of adrenal lymphoma and its diagnostic value of double enhancement. Materials and Methods Eight cases of B-cell non-Hodgkin’s lymphoma confirmed by surgery and pathology were retrospectively analyzed. The CT scan and double-phase enhanced examination were performed preoperatively. All cases of imaging data were analyzed by the reading of three senior physicians to determine the lesion size, shape, edge, density and intensity and type of enhancement. Among them, 2 patients underwent MR examination at the same time. Results Of the 11 lesions in 8 cases of adrenal lymphoma, 3 cases were bilateral and 5 cases were unilateral. The lesions were oval in 8 and triangular in 3. Tumor diameter 4.1 ~ 10.7 cm, an average of 6.3 cm. CT scan density of 10 lesions was relatively uniform, a lesion density was not uniform, all lesions were higher than most adrenal tumors CT scan value of 24.1 ~ 35.2 HU, an average of 25.5 HU; double enhanced arterial stage mild enhancement , Uniform enhancement of 4 lesions, uneven enhancement of 7 lesions, arterial phase CT value of 28.3 ~ 44.7 HU, an average of 31.6 HU; moderate portal vein enhanced all the lesions tend to be uniform, the portal venous phase CT value of 36.4 ~ 62.6HU, an average of 48.7 HU. Conclusions The density of adrenal lymphoma is relatively uniform and the density is higher than that of most adrenal neoplasms. The necrosis is rare or small in scope. The two-phase enhancement is mild to moderate progressive delaying enhancement and the enhancement is more uniform.
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