脾脏单发肿瘤或肿瘤样病变的CT表现

CT manifestations of single splenic tumor or tumor-like diseases

目的探讨脾脏单发肿瘤或肿瘤样病变的CT表现。方法回顾性分析18例经手术病理证实的脾脏单发肿瘤或肿瘤样病变的临床表现及CT特点。结果 18例单发脾脏肿瘤或肿瘤样病变中,血管瘤2例,其中1例明显强化,1例边缘结节状强化;3例淋巴管瘤边缘及分隔轻度强化;3例较大窦岸细胞血管瘤动脉期明显强化,门静脉期逐渐均匀强化,延迟期强化与周围组织相仿,另2例边缘轻度强化;3例较大硬化性血管瘤结节样转化病灶内见"辐轮状钙化"及"辐轮状强化",另1例病灶内见液化坏死;1例上皮样血管内皮瘤平扫及增强无特征性改变;1例巨块型淋巴瘤动脉期可见"血管漂浮"征;2例淋巴瘤呈轻度均匀强化。结论 CT可较清晰地显示脾脏病灶的大小、形状、密度、边界及强化程度,对脾脏单发肿瘤或肿瘤性病变有较高的诊断价值。

Objective To explore the CT manifestations of single splenic tumor or tumor-like diseases. Methods Clinical manifestations and imaging characteristics of 18 cases with single splenic lesions confirmed by surgery and pathology were analyzed retrospectively. Results One of splenic hemangiomas was enhanced obviously and the other showed the selvage nodular enhanced. The edge and separation enhanced mildly in 3 Cases of splenic lymphangioma. Three large lesions of littoral cell angioma enhanced obviously at arterial phase and homogeneously at portal vein period, and then enhanced similar to surrounding tissue in delay period, the other 2 showed the edge enhanced mildly. The characteristics of wheel-like calcification and enhancement was seen in three large cases of splenic sclerosing angiomatoid nodular transformation, and liquefaction necrosis was seen in another one. A lesion of splenic epithelioid hemangioendothelioma had no characteristic changes by CT scan. The vessel floating sign was seen in a huge splenic lymphoma at arterial phase, and 2 splenic lymphoma enhanced mildly homogeneously. Conclusion CT could well demonstrate the size, shape, density, bordery and the enhancement of solitary splenic lesions. Single splenic tumor or tumorqike diseases could be diagnosed accurately by contrast-enhanced CT.