脾脏窦岸细胞血管瘤多层螺旋CT影像特征:附5例报道

MSCT Imaging Features of the Littoral Cell Angioma (LCA) in Spleen [5-Case Report]

目的探讨脾脏窦岸细胞血管瘤(LCA)的常规平扫和多层螺旋CT(MSCT)动态增强表现。材料与方法回顾性分析经手术病理证实的5例脾脏窦岸细胞血管瘤(LCA)的多层螺旋CT平扫及动态增强表现。结果 5例LCA患者脾脏体积增大,CT平扫病灶呈弥漫分布,大小不一,自数毫米至数厘米不等的等密度及稍低密度结节,无囊变坏死区,1例脾脏内见2个稍高密度结节。多层螺旋CT动态增强扫描,动脉期病灶内部呈轻-中度不均匀强化,较平扫显示更多边界清楚的小病灶,门静脉早期病灶呈进行性强化,自内部向外周填充;大部分病灶延迟强化,门静脉后期与脾脏实质呈等密度。MSCT同时发现合并脾脏海绵状血管瘤和单纯性囊肿1例,合并横结肠腺癌和盆腔畸胎瘤1例。结论脾脏LCA弥漫分布,多层螺旋CT动态增强表现为自病灶内部向外的渐进性增强和延迟强化,病灶在延迟扫描与脾脏呈等密度。多层螺旋CT动态增强检查可为脾脏窦岸细胞血管瘤的提供可靠的诊断。

Objective To evaluate the findings of splenic littoral cell angioma （ LCA ） by using the multislice spiral computed tomography（MSCT）. Materials and methods MSCT imaging features of splenic littoral cell angioma（ LCA ） of five patients confirmed pathologically were retrospectively analyzed. Results MSCT imaging showed volume increase of spleen, and various size lesions throughout the spleen were iso-dense and slightly low-density nodules without cystic necrotic area in four cases, and two slightly high-density nodules showed in one case. MSCT dynamic enhancement showed that most lesions were light to moderate inhomogeneous enhancement with clear boundary on arterial phase, and progressive enhancement filled from internal to outward part on early portal phase. Most lesions appeared with delayed contrast filling, and showed iso-dense compared with spleen parenchyma on late portal phase. one case LCA associated with splenic cavernous hemangioma and simple cyst, one case with transverse colon tubular adenocarcinoma and pelvic teratoma. Conclusion Splenic LCA show various size lesions throughout the spleen, and progressively enhanced lesions from internal to outward part, and iso-dense compared with spleen parenchyma in most lesions on late portal phase. MSCT dynamic enhancement scan may be an important method for diagnosis of splenic littoral cell angioma.