摘要
目的提高原发性胃淋巴瘤的CT诊断水平。方法收集17例经胃镜活检和手术证实为原发性胃淋巴瘤。17例CT检查中,3例扫描前10min口服3%泛影葡胺1 000ml,14例口服等渗甘露醇800～1 000ml。平扫后行动脉期和静脉期增强扫描,动脉期延迟25～30s,静脉期延迟70s。分析CT表现。结果17例PGML中,病变位于多位于胃窦(15例,占88．2%)和胃体(14例,占82．3%),且多同时累及胃窦和胃体(12例,占70．6%)。CT表现为胃壁增厚17例,伴有肿块4例,形成直径2．5cm以上大溃疡4例。17例胃壁均增厚为0．6～4cm,14例(82．3%)增厚胃壁增强幅度为14HU～25HU的轻、中度强化。增厚胃壁强化均匀15例,见小片状坏死2例。胃腔无明显狭窄且三期扫描形态可变7例,以胃壁增厚为主的浸润型14例(82．3%),肿块型3例,溃疡型4例。肝脏均未见转移性病灶。结论原发性胃淋巴瘤主要位于胃窦和胃体,CT主要表现为浸润型,密度均匀,呈轻、中度均匀强化,可伴有大溃疡形成,在CT三期扫描中胃的形态可变。
Purpose To improve CT diagnose of primary gastric malignant lymphoma(PGML). Methods 17 cases of PGML proved pathologically by gastroscope and operation were collected.17 received CT examinations,3 patients ingested 3% diatrizoate solution 1 000ml and the other 14 patients ingested 800～1 000ml of 2.5% osmotic mannitol 10 minutes before CT scanning.All patients received unenhanced and contrast-enhanced scanning with arterial phase delayed 25～30s and portal venous phase delayed 70s.The CT findings were analysed.Results Tumor mainly involved gastric antrum(18 cases,85.7%)and body(17 cases,81%)and involved gastric antrum and body(15 cases,71.4%)simultaneously.The CT findings were 17 cases of mural thickening with the thickness between 0.6～4cm,4 cases ofmasses,4 cases of ulcers.14 causes(82.3%)of the thickened wall enhanced mildly of moderately,15 cases enhanced homogeneously and 2 cases of little patchy necrosis was seen in thickened wall.14 cases(82.3%)were infiltrating type,3 cases were mass type and 4 cases were ulcer type.No metastasis in liver was found in every case.Conclusion Primary gastric malignant lympboma mostly involves gastric antrum and body,CT findings were mostly infiltrating type with homogeneous density and mild or moderate enhancement,accompanied with large ulcer.The gastric modality is variable in CT three phase scan.
出处
《中国实用医药》
2007年第6期76-77,共2页
China Practical Medicine
关键词
胃淋巴瘤
CT
论断
Primary gastric malignant lymphoma
CT
Diagnose
