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腹部局限性Castleman病的MRI诊断及鉴别
作者:张军  王春  沈威 
单位:舟山市普陀区人民医院放射科  浙江 舟山 316100 温州医科大学附属慈溪医院放射科  浙江 宁波 315300 
关键词:巨淋巴结增生/放射摄影术 巨淋巴结增生/病理学 磁共振成像 腹部 体层摄影术 X线计算机 诊断 鉴别 回顾性研究 
DOI:R730.44
出版年,卷(期):页码:2017,32(6):543-546
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摘要:

目的 探讨MRI对腹部局限性Castleman病(localized Castleman's disease,LCD)的诊断价值。方法 回顾性分析7例经病理学证实的腹部LCD的MRI资料。结果 7例中5例位于腹膜后间隙,1例位于肝胃间隙,1例位于小肠系膜。6例呈肾形,1例哑铃形,边界均较清晰。肿块最大径约4.2~8.6 cm,平均5.9 cm。MRI平扫7例T1WI上均呈等信号,T2WI上较高信号;6例内部信号较均匀,1例信号不均。弥散加权成像序列(diffusion weighted imaging,DWI)均呈不同程度高信号,7例周边均见斑点状、条状卫星灶。动态增强动脉期7例病灶呈中等及以上程度强化,静脉期均持续明显强化;6例强化均匀,1例强化不均,内见无强化坏死囊变区。周边卫星灶强化与主灶相仿,其中2例见滋养血管明显强化。结论 MRI可以显示腹部LCD的一些病理学改变,对其诊断及鉴别具有较大价值。

Objective To investigate the diagnostic value of MRI for abdominal localized Castleman's disease(LCD). Methods The MRI data of 7 pathologically confirmed abdominal LCD cases were analyzed retrospectively. Results Among the 7 cases,5 cases were located in the retroperitoneal space,one case was located in the hepatogastric space,and one case was in the mesostenium. Besides,6 cases showed kidney-shaped appearance and one case showed dumbbell-shaped appearance. All cases had clear boundary. The maximum diameters of the tumor was 4.2-8.6 cm,with an average of 5.9 cm. For the unenhanced MRI scan,all 7 cases showed intermediate signal intensity on T1WI and rela-tively high signal intensity on T2WI. The inner signal was homogenous in 6 cases and was inhomogenous in one case. For diffusion weighted imaging (DWI),all cases showed high signal intensity of different degrees. Small satellite nodes of spotted or striped shapes were observed in the margin areas of all cases. On dynamic enhanced MRI,the lesions of all 7 cases showed intermediate to high enhancement on the artery-phase,and persistent high enhancement on the venous-phase. Moreover,the enhancement of 6 cases were homogenous and one case was inhomogenous,without any detectable enhanced necro-tic or cystic area. Finally,the enhancement of peripheral satellite nodes was similar with the main lesions. Obvious enhancement of nutritious vessels was observed in two cases. Conclusion MRI can detect some pathological changes of abdominal LCD and is important for the disease diagnosis and differential diagnosis.

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