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目的探讨超声在儿童原发性肠道淋巴瘤诊断中的价值。方法选择2011年1月至2016年6月深圳市儿童医院儿童原发性肠道淋巴瘤的患儿12例,与手术病理检查结果对照,对患儿临床及术前超声表现进行分析。结果术前超声显示,12例原发性肠道淋巴瘤分别位于回盲部5例、回肠2例、空肠3例、横结肠1例、升结肠1例;其中8例超声表现为肠管局部低回声或极低回声肿块,与肠壁分界不清,彩色多普勒显示血流信号丰富呈点、条状,术前表现为肿块型肠肿瘤;4例超声表现为沿肠管长轴方向分布的弥漫性肠壁增厚,呈均匀或不均的低回声或极低回声,局部肠蠕动减弱或消失,肠腔内呈狭长、固定的气体高回声,彩色多普勒示血流信号丰富,术前表现为弥漫型肠肿瘤。12例患儿的肿块内均未显示明显的液性无回声区及钙化强回声。手术病理均确诊为非霍奇金淋巴瘤(伯基特淋巴瘤8例,滤泡性淋巴瘤2例,弥漫大B细胞性淋巴瘤1例,B淋巴母细胞性淋巴瘤1例)。结论儿童原发性肠道淋巴瘤多以急腹症为主要临床表现,超声表现有助于识别肠原发病变,对提高儿童肠道淋巴瘤的早期诊断、改善预后有积极作用。
Objective To investigate the value of ultrasound in the diagnosis of primary intestinal lymphoma in children. Methods Twelve children with primary intestinal lymphomas from January 2011 to June 2016 in Shenzhen Children’s Hospital were selected and compared with the results of surgery and pathology to analyze the clinical and preoperative ultrasound findings. Results Preoperative ultrasound showed that 12 cases of primary intestinal lymphoma were located in the ileocecal region in 5 cases, ileum in 2 cases, jejunum in 3 cases, transverse colon in 1 case, ascending colon in 1 case; 8 cases of ultrasound showed intestinal hypoechoic Or very hypoechoic mass, unclear boundary with the intestinal wall, color Doppler showed that the blood flow signal was rich in spots, strips, preoperative manifestations of mass type intestinal tumor; 4 cases of ultrasound showed along the long axis of the intestine distribution diffuse Intestinal wall thickening, was uniform or uneven hypoechoic or hypoechoic, partial bowel movements weakened or disappeared, the intestine was narrow, fixed gas hyperechoic, color Doppler showed rich blood flow signal, preoperative The performance of diffuse intestinal tumors. None of the 12 children showed any significant anechoic area and calcified echogenic mass within the mass. The pathology was confirmed as non-Hodgkin’s lymphoma (Burkitt’s lymphoma in 8 cases, follicular lymphoma in 2 cases, diffuse large B cell lymphoma in 1 case, B lymphoblastic lymphoma in 1 case). Conclusion Most children with primary intestinal lymphoma as the main clinical manifestations of acute abdomen, ultrasound findings help identify the primary lesion of the intestine, to improve early diagnosis of intestinal lymphoma in children and improve the prognosis of a positive role.