| 张丽娜,刘爱连,时畅,张秋萍.MRI诊断局限型巨大淋巴结增生症[J].中国医学影像技术,2013,29(6):981~984 |
| MRI诊断局限型巨大淋巴结增生症 |
| MRI in diagnosis of localized Castleman's disease |
| 投稿时间：2012-11-04 修订日期：2013-01-29 |
| DOI： |
| 中文关键词: 巨淋巴结增生 扩散磁共振成像 诊断显像 |
| 英文关键词:Giant lymph node hyperplasia Diffusion magnetic resonance imaging Diagnostic imaging |
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| 中文摘要: |
| 目的 探讨MRI诊断局限型巨淋巴结增生(LCD)的价值。 方法 回顾性分析25例病理学确诊的LCD患者的MR平扫、增强扫描及DWI资料,并与临床和病理学结果对比。 结果 25例LCD中,位于纵隔10例,颈部3例,腹膜后12例;均为透明血管型,以单发病灶为主(24/25,96.00%),形态多为圆形或卵圆形(23/25,92.00%),边缘多光滑规整(23/25,92.00%);MR平扫16例为T1WI均匀等稍低信号、T2WI均匀稍高信号,4例病灶内T2WI呈斑片状高信号,3例T1WI及T2WI为边缘裂隙样低信号,2例T2WI中心区低信号;动态增强扫中,6例动脉期显著均匀强化,延迟期仍持续均匀强化,2例动脉期病灶边缘强化,延迟期持续均匀强化,3例动脉期软组织区域显著强化,延迟期见分隔样强化,2例动脉期明显强化,延迟期内见线状及裂隙样不强化影;病灶包膜强化完整、连续。DWI中4例表现为均匀一致稍高信号、4例为斑片状高低混杂信号、2例中心区裂隙状低信号;病灶实质区平均ADC值为(1.78±0.14)×10-3 mm2/s,液化、囊变区平均ADC值为(2.98±0.51)×10-3 mm2/s 。 结论 MRI可准确显示LCD的发生部位、病灶形态及强化方式,尤其对病灶包膜的显示更清晰;DWI在显示病变范围和内部结构方面较常规MRI更佳。 |
| 英文摘要: |
| Objective To explore the diagnostic value of MRI for localized Castleman's disease (LCD). Methods Manifestations of plain MRI, dynamic enhanced MRI and DWI of 25 patients with LCD confirmed by pathology were retrospectively analyzed and compared with the clinical and pathological results. Results Lesions in all the 25 patients were found to be hyaline-vascular type Castleman's disease, which located at mediastinum (n=10), neck (n=3) or retroperitoneum (n=12). Single lesion was detected in most cases (24/25, 96.00%) as round or ellipse soft tissue mass (23/25, 92.00%) with smooth and regular edge (23/25, 92.00%). In plain MRI, 16 patients manifested as isointensity or slightly hypointensity relative to the skeletal muscle on T1WI and hyperintensity on T2WI, 4 patients as patchy hyperintensity on T2WI, 3 patients as rim fissured hypointensity both on T1WI and T2WI, and 2 as hypointensity at the center on T2WI. Enhanced MRI of 13 patients revealed obvious homogeneous enhancement (6 patients) and rim enhancement (2 patients) in arterial phase with continuous enhancement in delayed phase, soft tissue enhancement (3 patients) in arterial phase with separated enhancement in delayed phase, and obvious enhancement (2 patients) in arterial phase with fissured non-enhanced areas in delayed phase. The enhancement of lesion's capsule was intact and continuous. In 10 patients underwent DWI, 4 patients manifested as uniform hyperintensity, 4 patients as the patchy level mixed signal and 2 patients as fissured hypointensity signal at the center. The mean ADC values of substantial and liquefied cystic part of lesions were (1.78±0.14)×10-3 mm2/s and (2.98±0.51)×10-3 mm2/s, respectively. Conclusion MRI can accurately descript the location, morphology and enhancement pattern of LCD, especially the lesion's capsule. DWI is superior to conventional MRI in observing the extent and internal structure of LCD lesions. |
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