脾脏窦岸细胞血管瘤CT及MR影像表现与病理结果的关系

Relationship between CT and MR features and pathological features in littoral cell angioma

目的探讨脾脏窦岸细胞血管瘤(LCA)的CT和MR的影像特点及与病理特征的联系,以提高其诊断水平。方法回顾性分析陆军军医大学附属新桥医院经病理学证实的8例脾脏窦岸细胞血管瘤的CT或MR资料及病理特征,并复习相关文献。结果 8例患者脾脏均不同程度增大,其中7例病灶多发,1例病灶单发。多发病灶CT平扫表现为低密度,增强扫描病灶由外向内或/和由内向外逐渐强化; MR平扫T1WI加权呈等或稍低信号、T2WI加权呈高信号,病灶内可见点状低信号影("雀斑征"),DWI加权呈明显高信号,增强后病灶强化与CT强化方式类似,病灶数目经历"由少到多"再"由多到少"的过程。病理上所有病例免疫组化同时表达血管内皮细胞与组织细胞相关抗原。结论脾脏窦岸细胞血管瘤在CT及MR上的特征表现与其病理特点有一定联系,同时掌握其影像特点及病理特征有利于提高对脾脏窦岸细胞瘤的术前诊断水平。

Objective To explore the relationship between CT features and pathological features of CT and MR of littoral cell angioma (LCA) and to improve its diagnostic level. Methods Retrospective analysis of CT or MR data and pathological features of 8 cases of littoral cell angioma confirmed by pathology,and review related literatures. Results The spleen enlarged in 8 cases. Among them,7 cases had multiple lesions and 1 case had single lesion. CT plain scan of multiple lesions showed low density,and enhanced scan gradually enhanced from outside to inside or/and from inside to outside; T1WI weighted MR plain scan showed equal or slightly low signal,and T2WI weighted high signal. There were low signal shadows (" freckles sign") and high signal intensity on DWI. The enhancement of the lesion after enhancement is similar to that of CT. The number of lesions experienced a process of " from less to more" and " from more to less". Pathologically,all cases were immunohistochemically expressed both vascular endothelial cells and histocyte associated antigens. Conclusion The characteristics of littoral cell angioma on CT and MR are related to its pathological features. At the same time,mastering its imaging features and pathological features is beneficial to improve our preoperative diagnosis of littoral cell angioma.