2015 年第 5 期 第 13 卷

10例肝脏淋巴瘤的影像学表现分析

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关键词：肝脏淋巴瘤CTMRI

• 摘要：
• 【摘要】目的 探讨肝脏淋巴瘤的影像学特点。方法 回顾性分析10例初诊未治的肝脏淋巴瘤患者的临床表现、病理类型与影像学表现。结果 10例均为B细胞型非霍奇金淋巴瘤（4例原发性，6例继发性）。表现为单发肿块型4例，多发结节型4例，浸润型2例。3/4例CT平扫呈均匀低密度，6/6例CT增强扫描呈轻度强化，强化程度低于正常肝实质。4例MRI平扫者，T1WI呈低信号，T2WI及脂肪抑制序列呈均匀中高信号，2例DWI扫描呈明显扩散受限，2例行MR增强扫描呈轻度强化。4/8例有血管穿行肿瘤但无明显受侵征象。7/10例伴有肝脏区域淋巴结侵犯。原发肝淋巴瘤的影像表现与继发性相仿。结论 肝脏淋巴瘤的影像表现可多种多样，多数呈密度/信号均匀，增强后呈轻度强化，血管于肿瘤内穿行而无受侵是肝淋巴瘤的较为特征性表现。
• Objective To evaluate the imaging features of hepatic lymphoma. Method A retrospective review was performed on 10 patients with histologically proved hepatic lymphoma and their clinical manifestations, histological types and imaging features were analyzed. Result All of 10 cases were B-cell non-Hodgkin's lymphoma (4 primary, 6 secondary). Four cases appeared as solitary mass type, four cases appeared as multiple nodules type, and two cases appeared as diffuse infiltrative type. 3/4 cases showed a uniform hypodense on plan CT scan , 6/6 cases showed mild enhancement that lower than liver parenchyma on enhanced CT scan. Four cases demonstrated hypointense on T1WI, homogeneous hyperintense on T2WI and T2/FS (fat suppression sequences). Two cases demonstrated diffusion limited on DWI. Two cases demonstrated mild enhancement on contrast-enhanced MR scans. The special performance that the vascular pass through the tumors but not invaded by the tumors were found in 4/8 cases. 7/10 cases were combined with regional lymph nodes involvement. Primary hepatic lymphoma has the similar imaging performance with secondary hepatic lymphoma. Conclusion CT and MRI manifestations of hepatic lymphoma are variety, most of which showed uniform density and (or) intensity, and mild enhancement. The special performance that the vascular pass through the tumors but not invaded by the tumors is the characteristic feature of hepatic lymphoma.