原发性小肠淋巴瘤的CT和MRI表现

目的分析原发性小肠淋巴瘤（Primary small intestinal lymphoma,PSIL）的CT和MRI表现。方法回顾性分析经手术、病理证实的28例PSIL患者的CT和MRI表现,分析肿瘤的位置、形态、密度或信号、强化方式。结果该组28例PSIL病例均为非霍奇金淋巴瘤,好发于回肠末端或回盲瓣（占53.6%）;CT显示受累肠壁增厚或形成肿块,大多数呈局部或弥漫性环形增厚（占53.6%）,密度均匀,增强扫描轻中度均匀强化;75.0%的病例伴有肠管周围肠系膜、腹膜后淋巴结肿大。MRI显示病变呈稍长T1、稍长T2信号,DWI呈高信号,增强扫描轻中度均匀强化。结论 PSIL的CT和MRI表现具有一定特征性,在PSIL的诊断与鉴别方面起重要作用。

CT and MRI Manifestations of Primary Small Intestinal Lymphoma

Objective To analyze the CT and MRI findings of primary small intestinal lymphoma（PSIL）. Methods 28 cases of PSIL confirmed by surgery and pathology were analyzed retrospectively. Tumor location, shape, density or signal intensity and enhancement pattern were studied at CT and MRI. Results All 28 cases were confirmed to be non-Hodgkin lymphoma. 53.6% cases were found in terminal ileum or ileocecal valve. Unenhanced CT images displayed thickening wall or mass with homogeneous density, and 53.6% cases were found localized or diffuse annular thickening wall. Contrast enhanced CT images demonstrated mild to moderate enhancement. 75.0% cases showed lymphadenectasis in abdominal cavity or retroperitoneal area. PSIL were manifested as thick intestinal wall or a mass with slightly hypointensity signal on T1 weighted image, hyperintensity on T2 weighted images, hyperintensity on DWI images and mild to moderate homogeneous enhancement on contrast enhanced Tl weighted images. Conclusion There are some CT and MRI features of PSIL, which are valuable in differential diagnosis of PSIL.