临床肿瘤学杂志

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恶性血液病肝脏浸润形成占位性病变的超声和CT表现

刘莎,吴敏,金志斌,张捷   

  1. 210008 南京 南京鼓楼医院超声诊断科
  • 收稿日期:2015-07-31 修回日期:2015-11-12 出版日期:2016-01-31 发布日期:2016-01-31
  • 通讯作者: 吴敏

Sonographic and CT characteristics of hepatic mass relating to liver involvement in hematologic malignancy

LIU Sha,WU Min,JIN Zhibin,ZHANG Jie   

  1. Department of Ultrasound,Nanjing Drum Tower Hospital,Nanjing 210008, China
  • Received:2015-07-31 Revised:2015-11-12 Online:2016-01-31 Published:2016-01-31
  • Contact: WU Min

摘要: 目的 探讨恶性血液病肝脏浸润形成占位性病变的超声及CT特点,以提高确诊率。方法 回顾性分析2012年4月至2015年5月16例恶性血液病肝脏浸润形成占位患者的超声及CT表现;其中非霍奇金淋巴瘤9例,霍奇金淋巴瘤2例,多发性骨髓瘤1例,急性髓性白血病2例,急性淋巴细胞白血病1例,慢性淋巴细胞白血病1例。结果(1)超声表现:主要为多发性小病灶,少数为单发病灶;大部分病灶形态规则,为圆形、类圆形、椭圆形,少数形态不规则;13例病灶为低回声,1例为混合回声,2例为高回声。彩色多普勒血流成像技术(CDFI)提示乏血供。(2)CT表现:平扫肝脏占位主要为多发性低密度小病灶,增强扫描无强化或仅轻度强化。(3)肝右叶病灶数量多于肝左叶。(4)非霍奇金淋巴瘤、霍奇金淋巴瘤、多发性骨髓瘤以及白血病在肝脏浸润形成占位性病变的超声及CT表现有类似的特点。结论 恶性血液病肝脏浸润形成占位有一定的影像学特征,超声与CT联合检查可作为首选的无创性影像学诊断方法。

Abstract:

Objective To investigate the sonographic and CT features of hepatic masses caused by liver involvement in hematological

malignancies in order to improve diagnostic acurracy. Methods From April 2012 to May 2015,16 patients with hepatic masses caused by liver involvement in hematologic malignancies were respectively analyzed. Hepatic masses were present in patients with non-Hodgkin's lymphoma(9/16),Hodgkin's disease(2/16),multiple myloma(1/16),acute myeloblastic leukemia(2/16),acute lymphocytic leukemia(1/16)and chronic lymphocytic leukemia(1/16). Results The most frequent sonographic appearance was multiple small focal lesions,and less frequent appearance was single lesions. Most lesions showed regular round,round like or oval shapes,while few lesions showed irregular shapes. The hypoechoic lesions were found in 13 cases,while mixechoic and hyperechoic lesions were found in 1 and 2 cases,respectively. Poor or no color flow signal was found in the lesions.Unenhanced CT showed that multiple focal hypoattenuating lesions were in most cases.Enhanced CT showed no evident enhancement or slight enhancement. More lesions were found in right hepatic lobes than in left lobes. The sonographic and CT features of hepatic masses caused by liver involvement in hematological malignancies,including non-Hodgkin's lymphoma,Hodgkin's disease,multiple myloma,acute and chronic leukemia,are similar. Conclusion Ultrasound and CT show certain featrures in hepatic masses caused by liver involvement in hematological malignancies. The combination of ultrasound and CT is preferred as non-invasive imaging diagnostic method.

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