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1、第22卷第20期中国现代医学杂志Vol.22No.202012年7月ChinaJournalofModernMedicineJul.2012文章编号：1005-8982（2012）20-0091-05小肠恶性淋巴瘤的影像学表现陈留斌，王毅，李然，石丹凤，代波（第三军医大学大坪医院野战外科研究所放射科，重庆400042）摘要：目的分析小肠恶性淋巴瘤的影像特点，提高对该病的认识及术前诊断率。方法收集23例经手术和病理报告证实为小肠恶性淋巴瘤患者的胃肠道造影、CT及临床资料，回顾性分析其胃肠道造影和CT影像特征，并与手术和病理学结果进行对照。结果肿瘤发生于回肠19例，空肠1例，十二
2、指肠1例，2例为空回肠同时受累。胃肠道造影表现为小肠局部瘤样扩张9例，肠管狭窄6例，腔内充盈缺损4例，其中3例可见龛影。CT检查12例，表现为肠壁增厚9例，其中2例伴肠腔扩大，腔内肿块3例，肠系膜浸润或淋巴结肿大3例，累及大网膜1例。胃肠道造影的定位诊断准确率为87.0%，但定性诊断的准确率仅为34.8%。CT的定位诊断准确率为100%，定性诊断准确率为75.0%。结论CT能够对小肠恶性淋巴瘤提供更为全面准确的评价，常规胃肠道造影与CT检查相结合有助于制定更为恰当的治疗计划。关键词：淋巴瘤；小肠；胃肠道造影；体层摄影术；X线计算机中图分类号：R735.32；R445文献标识码
3、：BImagingcharacteristicsofmalignantlymphomaofthesmallbowelCHENLiu-bin,WANGYi,LIRan,SHIDan-feng,DAIBo(DepartmentofRadiology,DapingHospital&ResearchInstituteofSurgery,theThirdMilitaryMedicalUniversity,Chongqing400042,P.R.China)Abstract:【Objectives】Toanalyzetheimagingfeaturesofmalignantlymphom
4、aofthesmallbowel,inordertofacilitateitsrecognitionandpreoperativediagnosis.【Methods】Twenty-threepatientswithsmallbowelmalignantlymphomaconfirmedbyoperationandpathologywereselectedforthisstudy.TheirimagesofCT,conventionalGItractradiographyandclinicaldatawereanalyzedretrospectively.Theimaging
5、findingswerecomparedwithsurgicalandhistopathologicalresults.【Results】Accordingtothelocationsofthetumors,theileumwasinvolvedin19cases,thejejunumandduodenumin1caserespectively,andtheileumandje－junumin2casessimultaneously.ByGItractradiographicstudies,regionaldilatationofsmallbowelwasfoundin9ca
6、ses,bowelcanalstenosisin6,intraluminalfillingdefectin4casesandthreeofthemwithniche.12caseswereexaminedwithCT,bowelwallthickeningwasshowedin9casesandtwoofthemwithsegmentalboweldilatation,intraluminalmassin2cases,mesentericinfiltrationorlymphadenectasisin3casesandomentuminvolvedin1case.Theloc
7、ationandqualitativediagnosticaccuraterateofconventionalGItractradiographywere87.0%and34.8%respectively,however,thatofCTwere100%and75.0%.【Conclusion】CTismoreoverallandaccuratethanconventionalGItractradiographyfordiagnosingsmallbowelmalignantlymphomas.Conv
