肾上腺淋巴瘤CT及18F-FDG PET/CT主要特征分析

 目的 探讨肾上腺淋巴瘤的CT及¹⁸F-FDG PET/CT影像学征象,以提高对该病的诊断水平。方法 回顾性分析经手术病理证实10例肾上腺淋巴瘤的临床、影像及病理资料,均行CT平扫及增强扫描及¹⁸F-FDG PET/CT检查,观察和比较肿瘤发生的一般资料(年龄、性别),MSCT表现(部位、最大径、形态、密度、边界、强化方式、腹膜后淋巴结等情况,并计算各期强化率)和计算病灶SUVmax。结果 原发性肾上腺淋巴瘤7例,继发性肾上腺淋巴瘤3例;双侧病灶者7例,单侧病灶者3例,共计17侧病灶;肿瘤最大径不等,平均5.6 cm;肿块呈椭圆形共13侧,三角形3侧,1侧呈结节状增生;13侧边界清晰,4侧边界模糊;病灶平扫CT值平均40.4 Hu;动脉期平均强化率为24.28%;静脉期平均强化率37.46%;大部分(14/17)CT平扫及(13/17)增强密度较均匀一致,动脉期呈轻中度强化,门脉期呈进行性强化;2例发现腹膜后淋巴结肿大。均表现为¹⁸F-FDG高摄取,SUVmax为8.7～23.5,平均值为12.5。结论 肾上腺淋巴瘤CT表现具有一定特征,PET/CT 可准确显示肿瘤累及的范围和淋巴结,在诊断和治疗中具有重要的价值。

CT and 18F-FDG PET/CT features of adrenal lymphoma

Objective To explore the CT and ¹⁸F-FDG PET/CT features of adrenal lymphoma in order to learn more about this disease.Methods The clinical data on ten patients with adrenal lymphoma confirmed surgically and pathologically was retrospectively analyzed. All the patients received CT scan, and all of them were examined by ¹⁸F-FDG PET/CT. The general data on these patients, including age, gender, CT signs of the disease including the location, maximum diameter, shape, margin, density, the degree of enhancement and retroperitoneal lymph nodes, was analyzed and compared, while the rate of enhancement in each phase and the SUVmax value were calculated.Results There were seven cases of primary adrenal lymphoma and three cases of secondary adrenal lymphoma. There were a total of 17 lesions, including seven cases of bilateral lesions and three cases of unilateral lesions. The tumors were different in size, with an average size of 5.6 cm.Thirteen lesions were oval in shape, three triangular, and one irregular as nodular hyperplasia.Thirteen lesions had clear margins and the rest had ill-defined margins. The average value determined by CT plain scan was 40.4 Hu, the average rate of enhancement was 24.28% in the arterial phase, and 37.46% in the portal phase.Fourteen lesions were presented as homogeneous density on plain CT and homogeneous enhancement was observed in thirteen lesions. Lesions showed mild to moderate enhancement in the arterial phase, and the tumors showed gradual enhancement in the portal phase. Adrenal lesions showed intense FDG uptake on PET/CT with SUVmax ranging from 8.7 to 23.5, with a mean value of 12.5.Conclusions Primary and secondary adrenal lymphoma has some CT features. PET/CT can accurately demonstrate the extent of tumor involvement and lymph nodes, which can facilitate diagnosis and clinical management.