目的 探讨非霍奇金氏淋巴瘤（non-Hodgkin’s lymphoma，NHL）累及胃结肠韧带（gastrocolic ligament，GCL）的CT表现及其解剖学基础。 方法 回顾性分析26例经病理确诊的累及GCL的NHL病例，着重观察GCL的CT表现。 结果 GCL受累主要表现为GCL内淋巴结增大，增大淋巴结呈散在分布，未见淋巴结融合。增大淋巴结表现为均匀强化者25例，均匀强化合并环状强化者1例。有2例显示GCL增厚、局部呈饼状改变，伴有腹腔积液。 结论 熟悉GCL影像解剖学特点有助于累及GCL的NHL的CT诊断。
Objective To study the CT features of non-Hodgkin’s lymphoma (NHL) involvement of gastrocolic ligament (GCL) and its anatomic basis. Methods CT images of 26 patients with GCL involvement by the HNL were analyzed retrospectively. All cases were proved by pathology. Emphasis was placed on CT findings of the GCL. Results The main manifestation of GCL involvement was enlargement of lymph nodes in GLC. The enlarged lymph nodes were scattered and no lymph node fusion was observed. The enlarged lymph nodes showed uniform enhancement in 25 cases, and uniform enhancement combined with annular enhancement in 1 case. GCL thickened with local caked sign and peritoneal fluid collection in 2 cases. Conclusions Familiarity with the anatomical features of GCL is helpful for the CT diagnosis of NHL involving GCL.
[1] 李小秋, 李甘地, 高子芬, 等. 中国淋巴瘤亚型分布: 国内多中心性病例10002例分析[J]. 诊断学理论与实践, 2012, 11(2): 111-115. DOI: 10.3969/j.issn.1671-2870.2012.02.006.
[2] 郑璇, 雷志毅, 王玥瑶, 等. 腹部非霍奇金淋巴瘤CT增强表现与病理分级关系的探讨[J]. 临床放射学杂志, 2017, 36(3): 360-363. DOI: 10.13437/j.cnki.jcr.2017.03.020.
[3] 吴应行, 杨真露, 张道恩, 等. 7例肝脏原发性淋巴瘤的MSCT表现[J]. 临床放射学杂志, 2019, 38(9): 1667-1670. DOI: 10.13437/j.cnki.jcr.2019.09.021.
[4] Kulkarni NM, Pinho DF, Narayanan S, et al. Imaging for oncologic response assessment in lymphoma[J]. Am J Roentgenol, 2017, 208(1): 18-31. DOI: 10.2214/AJR.16.16180.
[5] 李媛, 杨志刚, 闵鹏秋, 等. 恶性淋巴瘤累及腹腔、腹膜后淋巴结的多层螺旋CT强化特征[J]. 中国医学影像技术, 2005, 21(2): 285-288. DOI: 10.3321/j.issn:1003-3289.2005.02.035.
[6] Kebede AA, Bekele F, Assefa G. Abdominal lymphoma: imaging work up challenges and recommendations n resource limited setup[J]. Ethiop Med J, 2014, 52(4): 197-206. PMID: 26410993.
[7] Neville A, Herts BR. CT characteristics of primary retroperitoneal neoplasms[J]. Crit Rev Comput Tomogr, 2004, 45(4): 247-270. PMID: 15554383.
[8] Mota MMS, Bezerra ROF, Garcia MRT. Practical approach to primary retroperitoneal masses in adults[J]. Radiol Bras, 2018, 51(6): 391-400. DOI: 10.1590/0100-3984.2017.0179.
[9] 管玥, 丁娜, 杨春波, 等. 进展期胃癌侵犯胃结肠韧带的MSCT表现[J]. 临床放射学杂志, 2014, 33(7): 1027-1030. DOI: 10.13437/j.cnki.jcr.2014.07.016.
[10] 金航, 闵鹏秋, 曾蒙苏, 等. 成年国人大网膜多层螺旋CT应用解剖学研究[J]. 解剖学报, 2006, 37(6): 695-697. DOI: 10.16098/j.jssn.0529-1356.2006.06.019.
[11] 赵爽, 宋彬, 黄子星. 腹膜反折结构的影像解剖及疾病播散途径[J]. 中国普外基础与临床杂志, 2021, 28(6): 811-815. DOI: 10.7507/1007-9424.202104066.
[12] 丁宁, 任安利, 翁爱婷, 等. 起源自小肠系膜胃肠道外间质瘤的CT表现[J]. 临床放射学杂志, 2021, 40(4): 742-745. DOI: 10.13437/j.cnki.jcr.2021.04.026.
[13] Liebermann-Meffert D. The greater omentum. Anatomy, embryology, and surgical applications[J]. Surg Clin North Am, 2000, 80(1): 275-293. DOI: 10.1016/s0039-6109(05)70406-0.
[14] Deng Y, Huang S, Huang M, et al. Gastrocolic ligament lymph?node dissection may increase the incidence of delayed gastric emptying after colon cancer surgery with D3 lymphadenectomy[J]. Surg Today, 2021, 51(6): 897-905. DOI: 10.1007/s00595-020-02200-6.
[15] Morón FE, Szklaruk J. Learning the nodal stations in the abdomen[J]. Br J Radiol, 2007, 80(958): 841-848. DOI: 10.1259/bjr/64292252.
[16]Zhang S, Chen M, Li CM, et al. Differentiation of lymphoma presenting as retroperitoneal mass and retroperitoneal fibrosis: evaluation with multidetector-row computed tomography[J]. Chin Med J, 2017, 130(6): 691-697. DOI: 10.4103/0366-6999.201606.
[17] 董鹏, 王滨, 李进, 等. 淋巴瘤累及小肠系膜的螺旋CT特征探讨[J]. 临床放射学杂志, 2008, 27(10): 1335-1337. DOI: 10.13437/j.cnki.jcr.2008.10.023.
[18]Hagtvedt T, Aal?kken TM, Smith HJ, et al. Enhancement characteristics of lymphomatous lymph nodes of the neck[J]. Acta Radiol, 2010, 51(5): 555-562. DOI: 10.3109/02841851003698198.
[19]Dong P, Chen JJ, Wang XZ, et al. Intraperitoneal tuberculous abscess: computed tomography features[J]. World J Radiol, 2015, 7(9): 286-293. DOI: 10.4329/wjr.v7.i9.286.
[20]Jin H，Min PQ. Computed tomography of gastrocolic ligament: involvement in malignant tumors of the stomach[J]. Abdom Imaging, 2007, 32(1): 59-65. DOI: 10.1007/s00261-006-9000-8.
[21] 杨玲, 胡春洪, 郭亮. 腹盆腔恶性淋巴瘤的少见CT表现[J]. 临床放射学杂志,2009, 28(11): 1489-1492. DOI: 10.13437/j.cnki.jcr. 2009. 11.021.
[22] 卢春燕, 闵鹏秋, 杨志刚, 等. 结核性腹膜炎的螺旋CT特征探讨[J]. 放射学实践, 2004,19(5): 344-347. DOI: 10.13609/j.cnki.1000-0313. 2004. 05.010.
京ICP备08002354号-3
