脾脏窦岸细胞血管瘤CT和MRI表现与病理对照

Littoral cell angiomas of the spleen:CT and MRI findings with pathological comparison

目的探讨脾脏窦岸细胞血管瘤(LCA)CT和MRI表现和病理学特征。方法搜集9例经手术病理证实为脾脏窦岸细胞血管瘤患者的临床及其影像学资料,回顾性分析其影像学及病理学特征。结果 9例均行CT平扫及动态增强扫描,其中3例行上腹部MRI平扫及动态增强扫描。9例脾脏体积不同程度增大,2例为单发病灶,病灶较大,边界清楚;其余7例为多发病灶,为多发类圆形小结节状,边界欠清。病灶CT平扫呈现低密度,MRI T1WI呈略低或等信号,T2WI上呈高信号,结节病灶内见散在细小T2低信号影,呈现"雀斑"样。DWI病灶呈现高信号。增强后病灶在CT和MRI上均呈现缓慢向心性强化。组织学上病灶由迷路样互相吻合的血管性腔隙构成,胞质内可见含铁血黄素颗粒。免疫组织化学染色提示肿瘤呈现血管内皮细胞和组织细胞抗原双重表达。结论脾脏窦岸细胞血管瘤影像学能够较准确反映其病理学特点,其影像学表现有一定的特异性。

Objective To investigate the CT and MRI imaging characteristics of littoral cell angiomas（LCA）of the spleen.Methods Nine patients with pathologically confirmed splenic LCA were included,the imaging findings and pathologic appearance were analyzed.Results All of nine patients showed splenomegaly,7patients had multiple small nodular splenic lesions,2patient had one huge mass.All foci were near iso-dense on plain CT images;On MRI,all the LAC demonstrated T1-hypointense and T2-hyperintense signals with punctual hypointense in the T2 WI,DWI showed an increased diffusion of he lesions compared to the normal appearing splenic tissue.After contrast enhancement,nodules were demonstrated slow progressive enhancement.Histologically,the tumors were composed of inosculated vascular spaces similar to the splenic sinuses with ingested hemosiderin.Conclusion CT and MR imaging of LCA has certain imaging characteristics and helpful for establishing the diagnosis.