红髓型脾脏错构瘤的MSCT影像表现特点

The MSCT Imaging Features of the Red Pulp Type Splenic Hamartoma

目的：探讨红髓型脾脏错构瘤（SH）的MSCT特点。方法：回顾性分析经手术病理证实的13例红髓型SH的临床及CT影像资料,所有病例均行64层螺旋CT平扫及增强扫描。结果：13例均为单发,共13个病灶,直径4.6~10.5 cm。CT平扫病灶呈等密度者9例,境界不清,呈稍低密度者4例,境界清楚,病灶内均无脂肪成分及钙化,坏死和囊变少见。增强后平扫呈等密度的9例病灶呈不均匀性斑片状轻度强化,平扫呈稍低密度的4例病灶呈不均匀性斑块状明显强化,随时间延迟所有病灶均呈渐进性均匀强化。延迟期病灶密度接近或等于周围正常脾实质的密度,其中误诊为脾脏血管瘤、恶性肿瘤各1例。结论：脾脏错构瘤不同于其他器官的错构瘤,有其自身特点：病灶内常无脂肪成分及钙化灶,当发现脾内单发等密度或稍低密度肿块,增强后病灶呈弥漫性不规则,不均匀性斑片状或斑块状强化,且随时间延迟呈渐进性均匀强化等特征时,应首先考虑脾脏错构瘤,且多为红髓型。

Objective： To investigate the MSCT imaging features of the red pulp type splenic hamartoma. Methods： Retrospective analysis of the clinical and CT imaging data of 13 cases of red pulp type SH confirmed by operation and pathology, All patients underwent 64 slice spiral CT plain scanning and enhanced scanning. Results： 13 cases were solitary, a total of 13 lesions, diameter of 4.6~10.5 cm, the plain CT scan showed is density in 9 cases, the state is not clear, showed slightly low density lesion in 4 cases, the realm of clear, all cases without fat component and calcification, cystic necrosis, rare, enhanced scan showed 9 patients with lesions density showed diffuse irregular, inhomogeneous patchy enhancement, scan showed slightly low density lesions of 4 cases showed diffuse irregular, uneven patches enhanced obviously, time delay lesions showed homogeneous enhancement in delayed phase of progressive, lesion density close to or equal to the surrounding normal splenic parenchymal density, which was misdiagnosed as malignant tumor of splenic hemangiomas, 1 cases in each. Conclusion： SH is different from the other organs of the hamartoma, has its own characteristics, intralesional often no fat component and calcification, when found in the spleen of solitary mass, enhanced lesions showed diffuse irregular, inhomogeneous enhancement patch or plaque, with the delay time is progressive uniform enhancement, should first consider splenic hamartoma, and more for the red pulp type.