原发性肝脏淋巴瘤的影像学诊断价值研究 [中文引用][英文引用]

 【摘要】目的:总结原发性肝脏淋巴瘤（PHL）的临床特征表现、CT及MRI影像学表现，探讨影像学检查对PHL的诊断价值，为临床诊治PHL提供可靠依据。方法: 回顾性分析海军军医大学第三附属医院2014年1月至2020年12月期间经病理证实且具有术前完整影像学资料的PHL 15例，其中CT 8例，MRI 7例，分析PHL的临床特征和影像学表现。结果: 15例PHL均无特异性的临床表现，11例为单发病灶，4例为多发病灶；13例多为类圆形，8例密度/信号均匀；7例病灶内可见坏死；增强扫描后9例表现为渐进强化，其中7例为单发结节，6例表现为持续强化；11例病灶内见“血管漂浮征”，即血管穿行无受侵表现。结论: PHL罕见，当临床表现及实验室诊断无特异性，肝内出现单发病灶，影像学表现为渐进强化及“血管漂浮征”，需考虑PHL的诊断，多发病灶表现出“血管漂浮征”对PHL的诊断有提示意义。

 [Abstract]  Objective  To summarize the clinical features, CT and MRI imaging findings of primary hepatic lymphoma (PHL), and investigate the diagnostic value of the imaging examination for PHL, so as to provide reliable basis for clinical diagnosis and treatment of PHL. Methods  A total of 15 patients with PHL confirmed by pathology and complete preoperative imaging data from January 2014 to December 2020 at Third Affiliated Hospital of Naval Medical University were retrospectively analyzed, including 8 cases with CT and 7 cases with MRI. The clinical features and imaging manifestations of PHL were analyzed. Results  All 15 patients with PHL had no specific clinical manifestations, 11 cases were single lesions and 4 cases were multiple lesions; 13 cases were mostly round, 8 cases had uniform density/signal; necrosis was seen in 7 cases; 9 cases showed progressive enhancement after enhancement scan, 7 of which were single nodules and 6 cases showed continuous enhancement. “Vascular floating sign” was seen in 11 cases, indicating no invasion of vessels. Conclusion  PHL is rare, and when the clinical presentation and laboratory diagnosis are not specific, the diagnosis of PHL should be considered when there is a single lesion in the liver with progressive enhancement and “vascular floating sign” on imaging. The diagnosis of PHL is suggested by the presence of multiple lesions with “vascular floating signs”.