脾硬化性血管瘤样结节性转化的CT表现并文献复习

CT features of sclerosing angiomatoid nodular transformation of the spleen and literature review

目的:探讨脾硬化性血管瘤样结节性转化(SANT)的CT诊断价值。方法:回顾性分析16例经手术病理证实的SANT的CT平扫及多期增强扫描表现。结果:(1)CT平扫:16例均表现为脾脏内单发的、类圆形低密度病变,边界清晰;边缘无分叶2例(2/16,占12.5%),浅分叶14例(14/16,占87.5%);5例周围见假包膜形成(5/16,占31.3%);16例病灶内均未见坏死及囊变区。(2)CT增强扫描:9例动脉期、静脉期边缘及分隔见轻度强化,病变内可见无强化的低密度区(9/16,占56.3%),7例见逐渐向心性充填的"轮辐样"强化影(7/16,占43.8%);10例延迟扫描可见对比剂逐渐向病变中心填充(10/16,占62.5%);11例病变中心区域可见不强化的裂隙样低密度区(11/16,占68.8%),7例周围正常血管影可见受压移位或变形(7/16,占43.8%)。结论:SANT的CT表现具有一定的特征性,有助于术前诊断。

Objective：To analyze the CT features of sclerosing angiomatoid nodular transformation（SANT）of the spleen.Methods：Totally 16 patients with histopathologically proven SANT were enrolled in this retrospective study.All patients underwent non-enhanced and dynamic contrast-enhanced CT scans.Results：①on-enhanced CT：solitary lesion was seen in all 16 patients.The lesions were well-defined and hypodense.14 cases were slightly lobulated（14/16,87.5%）and 2cases were non-lobulated（2/16,12.5%）.Pseudocapsule was observed in 5cases（5/16,31.3%）.There was no evidence of necrosis and cystic degeneration in all lesions.②namic contrast-enhanced CT：peripheral and septate enhancements were seen in 9cases（9/16,56.3%）in arterial and venous phases.Spoke-wheel shaped enhancement was seen in 7cases（7/16,43.8%）.10 cases showed centripetal enhancement（10/16,62.5%）;a hypointense stellate fibrous central scar was observed in 11cases（11/16,68.8%）.Adjacent vessels were compressed and displaced in 7cases（7/16,43.8%）.Conclusion：SANT has certain characteristics on CT,and will be helpful for the presurgical diagnosis.