多层螺旋CT对原发性胃肠道淋巴瘤的诊断及鉴别诊断

目的:探讨多层螺旋CT对原发性胃肠道淋巴瘤(PGIL)的诊断及鉴别诊断价值。方法:对我院经手术病理证实的原发性胃肠道淋巴瘤40例,临床影像学资料进行回顾性分析。结果:40例胃肠道淋巴瘤均为非霍奇金淋巴瘤,其中胃淋巴瘤31例,肠道淋巴瘤9例。多层螺旋CT表现胃壁弥漫性均匀增厚19例,均清晰显示“黏膜白线征”及“轨道征”。病变处胃肠道管壁增厚与管腔狭窄呈非一致改变39例。肠道“动脉瘤样扩张”4例。“汉堡包征”1例。临床影像学很少出现梗阻表现。结论:充分认识原发性胃肠道淋巴瘤典型的CT影像特征,有助于提高病变的术前诊断正确率。 

The Diagnosis and Differential Diagnosis of Primary Gastrointestinal Lymphoma by Multislice Spiral Computed Tomography

Objective: To investigate the value of multislice spiral computed tomography(MSCT) in the diagnosis and differential diagnosis of primary gastrointestinal lymphoma. Methods:The clinical imaging data of 40 cases of primary gastrointestinal lymphoma confirmed by surgery and pathology in our hospital were retrospectively analyzed. Results:40 PGILs all belonged to non-Hodgkin's lymphoma, including 31 cases of primary gastric lymphoma(PGL) and 9 cases of primary small intestinal lymphoma(PSIL). 19 cases of PGL showed diffuse homogeneous gastric wall thickening in MSCT. They all clearly showed mucosa white line sign and track sign. The wall thickening of the gastrointestinal tracts were not consistent with the stenosis of the lumens of the lesions occurred in 39 cases. 4 cases showed aneurysm-like intestinal dilatation. 1 case showed the hamburger sign. Clinical imaging rarely showed obstruction. Conclusion:To recognize the typical CT imaging features of primary gastrointestinal lymphoma, can improve the preoperative diagnostic accuracy of the disease.