CAJ | 학술논문

目的分析腹膜后局灶性Castleman病(LCD)的CT和磁共振成像(MRI)表现及其相关病理特征,探讨CT和MRI对LCD的诊断价值.方法回顾性分析13例经病理证实的腹膜后LCD患者的临床和影像学资料,13例患者均行CT检查,4例患者另行MRI检查.结果 13例腹膜后LCD中,透明血管型12例,混合型1例.病灶均为单发,多位于肾脏周围;病灶最大直径4.2～8.6 cm,平均5.9 cm;病灶轮廓较清晰,以肾形多见.CT平扫示,10例呈略低密度,3例等密度.MRI平扫T1 WI序列上4例呈等信号;T2WI序列上3例呈稍高信号,1例呈中等高信号.CT和MRI动态增强扫描表现相仿.CT动态增强扫描动脉期示,10例呈中等程度强化,2例显著强化,1例轻中度强化;5例强化较均匀,8例强化不均匀.CT动态增强扫描静脉期示,13例病灶均持续强化,8例动脉期不均匀强化的病灶,在静脉期强化范围扩大,其中2例病灶内部强化趋于均匀,6例见无强化低密度区;9例病灶周边可见单发或多发点状、斑条状卫星灶.结论 CT和MRI动态增强扫描结合MRI T2WI脂肪抑制序列对腹膜后LCD的诊断具有重要价值.
목적 분석복막후국조성Castleman병(LCD)적CT화자공진성상(MRI)표현급기상관병리특정,탐토CT화MRI대LCD적진단개치.방법 회고성분석13례경병리증실적복막후LCD환자적림상화영상학자료,13례환자균행CT검사,4례환자령행MRI검사.결과 13례복막후LCD중,투명혈관형12례,혼합형1례.병조균위단발,다위우신장주위;병조최대직경4.2～8.6 cm,평균5.9 cm;병조륜곽교청석,이신형다견.CT평소시,10례정략저밀도,3례등밀도.MRI평소T1 WI서렬상4례정등신호;T2WI서렬상3례정초고신호,1례정중등고신호.CT화MRI동태증강소묘표현상방.CT동태증강소묘동맥기시,10례정중등정도강화,2례현저강화,1례경중도강화;5례강화교균균,8례강화불균균.CT동태증강소묘정맥기시,13례병조균지속강화,8례동맥기불균균강화적병조,재정맥기강화범위확대,기중2례병조내부강화추우균균,6례견무강화저밀도구;9례병조주변가견단발혹다발점상、반조상위성조.결론 CT화MRI동태증강소묘결합MRI T2WI지방억제서렬대복막후LCD적진단구유중요개치.
Objective To analyze the CT and MRI findings and pathological characteristics of retroperitoneal localized Castleman's disease and discuss the diagnostic and differential value of CT and MRI.Methods CT,MRI and clinical data of retroperitoneal localized Castleman's disease,proved by surgery and pathology,of 13 patients were reviewed.Among them,all the 13 cases received CT,and 4 cases received MRI examination.Results Among the 13 cases,12 cases were of hyaline vascular type,and one was of mixed type.All foci were single mass and most foci located in the periphery of the kidney.The maximum diameter was 4.2 cm to 8.6 cm and the mean diameter of all tumors was 5.9 cm.The outline of most tumors was clear and kidney-shaped.On unenhanced CT,10 cases showed low density and 3 cases showed isodensity.On plain MRI,four cases showed iso-signal on T1WI,three cases showed slightly high signal on T2WI and one showed moderately high signal.The CT and MRI findings were similar on contrast enhanced scan.In arterial phase,10 cases showed moderate enhancement,2 cases showed significant enhancement and one case showed moderate enhancement.Five cases showed rather homogeneous enhancement and 8 cases showed heterogeneous enhancement.In venous phase,all the 13 tumors showed continuous enhancement.Eight cases showing heterogeneous enhancement in arterial phase showed expanded range,and among them two cases showed tending to be homogeneous enhancement.Six cases showed areas of low density without enhancement,and 9 cases were accompanied with single or multi-satellite punctuate or striped foci around the tumors.Conclusion Dynamic contrast-enhanced CT and MRI combined with MR T2WI fat-suppression are of great importance in the diagnosis and identification of retroperitoneal localized Castleman's disease.