脊柱原发性大B细胞淋巴瘤CT及MRI表现
摘要点击次数: 48   全文下载次数: 49   投稿时间:2017-03-17    
作者Author单位AddressE-Mail
田萍 TIAN Ping 湖州市中心医院MRI室, 浙江 湖州 313000 Huzhou Central Hospital MRI Room, Huzhou 313000, Zhejiang, China 13732396858@138.com 
江凯 JIANG Kai 宁波大学医学院附属医院影像科, 浙江 宁波 315020  
蔡志强 CAI Zhi-qiang 宁波市第一医院影像科, 浙江 宁波 315000  
王咏涛 WANG Yong-tao 宁波市李惠利医院放射科, 浙江 宁波 315000  
邓生德 DENG Sheng-de 宁波大学医学院附属医院影像科, 浙江 宁波 315020  
期刊信息:《中国骨伤》2017年,第30卷,第12期,第1141-1146页
DOI:10.3969/j.issn.1003-0034.2017.12.013
基金项目:
中文摘要:

目的:探讨脊柱原发性大B细胞淋巴瘤的CT及MRI表现。

方法:回顾性分析2011年3月至2015年8月经病理证实的23例脊柱原发性大B细胞淋巴瘤患者的临床表现及CT、MRI资料,男14例,女9例;年龄28~70岁,平均53.4岁。临床症状以脊柱区疼痛为主,少数伴周围神经症状。病程2周~3个月,平均9周。CT平扫9例,CT平扫及增强8例;21例MRI平扫及增强扫描;15例同时行CT及MRI检查;对病灶的部位、骨质改变、形态、密度/信号特点及强化特征进行观察,并与病理进行对照。

结果:病变部位及大小:颈椎1例,胸椎16例,腰椎2例,骶椎4例。肿块常较大,最大的横断面73 mm×125 mm。病变类型:23例中15例表现为骨质破坏型,7例为软组织肿块型,无骨髓浸润型。CT及MRI表现:CT示11例伴"云雾"状改变,6例伴压缩性骨折,并伴"浮冰"样改变,伴"袖套"样改变9例;11例伴椎管狭窄;增强扫描明显强化。MRI示T1WI均为稍低信号,T2WI均为稍高信号,信号不均,增强后强化明显,椎管狭窄16例,伴"袖套"样改变13例;椎间隙均无明显狭窄。CT及MRI表现对照:CT对骨质破坏细节的显示明显优于MRI,但其对病灶范围及其周围结构是否受累的显示不及MRI,MRI显示病灶的范围往往大于CT。病理:23例均为脊柱原发性大B细胞淋巴瘤。

结论:脊柱原发性大B细胞淋巴瘤发病年龄、部位及影像学表现有一定特征性。CT和MRI表现中"云雾"状、"浮冰"状骨质破坏及椎管内"袖套"样浸润对脊柱原发性大B细胞淋巴瘤的诊断有一定价值。
【关键词】脊柱  淋巴瘤  CT  MRI
 
CT and MRI manifestation of primary spinal large B cell lymphoma
ABSTRACT  

Objective: To investigate CT and MRI characteristics of primary spinal large B cell lymphoma.

Methods: CT and MRI data of 23 patients with primary spinal large B cell lymphoma confirmed by histopathology were retrospectively analyzed from March 2011 to August 2015. Among them,including 14 males and 9 females aged from 28 to 70 years old with an average of 53.4 years old. The clinical manifestation mainly focus on pain around spinal and minority peripheral nerve symptom. The courses of disease ranged from 2 weeks to 3 months with an average of 9 weeks. Nine patients underwent CT plain scan,8 patients underwent plain and enhanced CT;21 patients underwent MRI plain scan and enhanced;15 patients underwent CT and MRI examination. The location,bone changes,shape,density,signal intensity and enhancement characteristics of lesions were observed and compared with pathology.

Results: Location and size of lesion showed cervical vertebrae in 1 case,thoracic vertebrae in 16 cases,lumbar vertebrae in 2 cases,and sacral vertebrae in 4 cases. Mass was larger,the largest cross-sectional size of group was up to 73 mm×125 mm. CT examination showed that 11 cases with "cloud and mist" shape change,6 cases with compression fractures,and with "floating ice" shape change,9 cases with "oversleeve" shape change,11 cases with spinal stenosis; enhancement scan showed obvious reinforcement. MRI showed slightly low signal on T1WI and T2WI were slightly high signal,and signal was uneven,and enhancement scan showed obvious reinforcement,13 of 16 cases with spinal canal stenosis changed like"oversleeve",intervertebral space showed no significant stenosis. Comparison of CT and MRI showed the manifestation of bone destruction by CT was superior than that of MRI,but the range of lesion,and related surrounding structures were not better than MRI. MRI displayed the range of lesion usually bigger than CT. Pathology results showed that 23 patients were all primary spinal large B cell lymphoma.

Conclusion: Primary spinal large B cell lymphoma has certain features in age,location and imaging findings. The "cloud and mist","floating ice" and "oversleeve" shape bony destruction by CT and MRI has certain significance to diagnosis of primary spinal large B cell lymphoma.
KEY WORDS  Spine  Lymphoma  CT  MRI
 
引用本文,请按以下格式著录参考文献:
中文格式:田萍,江凯,蔡志强,王咏涛,邓生德.脊柱原发性大B细胞淋巴瘤CT及MRI表现[J].中国骨伤,2017,30(12):1141~1146
英文格式:TIAN Ping,JIANG Kai,CAI Zhi-qiang,WANG Yong-tao,DENG Sheng-de.CT and MRI manifestation of primary spinal large B cell lymphoma[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(12):1141~1146
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