脾脏良性血管源性肿瘤的影像学表现及病理对照研究

Primary splenic benign hypervascular tumor：MRI, CT and pathologic analysis

目的通过分析脾脏富血供良性血管源性肿瘤的影像学特点，为临床鉴别诊断提供帮助。方法回顾分析近6年来已确诊的21例脾脏血管瘤、7例脾脏错构瘤及5例窦岸细胞血管瘤CT及MR的影像学表现及临床病理资料，总结其影像学特征性表现。结果脾脏血管瘤常为多发，病灶体积一般较小，增强扫描早期较少见到边缘结节样强化；MR检查T2WI上为高信号，DWI上信号多高于周围脾组织。7例脾脏错构瘤均为单发，体积较大，病灶早期强化程度较血管瘤明显且呈延迟持续强化；MR检查T奠T2WI及DWI上信号低于周围脾组织。窦岸细胞血管瘤常表现为多发小结节，本组5例中4例伴有脾大、脾功能亢进的临床表现，MR检查T2WI及DWI上病灶信号高于周围脾组织。结论脾脏良性富血供肿瘤虽然其增强方式较为相似，但病灶在T2WI及DWI上的信号有各自特点，可为临床的鉴别诊断提供帮助。

Objective To assess the imaging features of primary splenic benign hypervascular tumors. Methods The imaging findings of 33 surgically treated patients were retrospectively analyzed including 21 cases of splenic hemangioma, 7 cases of splenic hamartoma and 5 cases of Littory-cell angioma. Results Splenic hemangioma commonly presented as small size and unhomogeneous mass; the enhancement mode was similar to classic liver hemangioma, but peripheral nodular-like en- hancement was seldom found; axial T2-weighted MR image showed several high-signal-intensity masses, but axial DWl MR image showed several low-signal-intensity masses. Splenic hamartoma was generally homogeneous and large mass, it was significantly enhanced comparing with splenic hemangioma; axial T2-weighted and DW MR image showed low-signal-intensity masses. Littory-cell angioma was generally multiple nodules, 4 of 5 cases had clinical symptoms of splenomegalia and hyper- splenia; the enhancement mode was similar to splenic hemangioma; axial T2-weighted and DW MR image showed high-sig- nal-intensity masses. Conclusion The CT and MRI findings of hypervascular tumors of the spleen show some distinct charac- teristic signs. MRI is particularly useful in the differential diagnosis of benign hypervascular splenic tumors.