脾脏原发性肿瘤29例多层螺旋CT影像分析

Analysis of characteristics of multi-slice spiral CT in primary splenic tumors

目的 分析脾脏原发性肿瘤的多层螺旋CT的平扫及强化表现,探讨其诊断价值.方法 回顾性分析29例经手术或活检病理证实的脾脏原发性肿瘤的螺旋CT影像表现.结果 良性肿瘤23例（脾囊肿9例,血管瘤7例,淋巴管瘤3例,肌纤维母细胞瘤2例,错构瘤2例）,临床表现腹部轻微不适或无症状;CT平扫为脾脏内单发或多发低密度或混杂密度肿块影,血管瘤、错构瘤可显示斑点状钙化,错构瘤可有钙化或脂肪密度.CT强化,脾囊肿无强化,血管瘤延迟强化,中心填充;淋巴管瘤无强化或间隔轻微强化,肌纤维母细胞瘤或错构瘤强化特点多样.恶性肿瘤6例（淋巴瘤3例,血管肉瘤2例,恶性纤维组织细胞瘤1例）,恶性肿瘤多有腹痛、消瘦等明显临床症状,CT平扫脾脏多肿大,肿块多较大,边界不清,少有钙化,可有转移;CT强化,淋巴瘤强化轻微,血管肉瘤延迟强化,恶性纤维组织细胞瘤不均强化.结论 多层螺旋CT扫描结合强化对脾脏原发肿瘤具有较高的诊断价值.

Objective To analyze the plain and enhanced features of multiple spiral CT in primary splenic tumors,and to evaluate the diagnostic value.Methods The spiral CT findings of 29 cases of splenic primary tumors proved by operation or biopsy were retrospectively analyzed.Results 23 cases of benign tumors （9 cases of splenic cyst,7 cases of hemangioma,3 cases of lymphangioma,2 cases of myofibroblastic tumor,hamartoma in 2 cases）,clinical manifestations of mild abdominal discomfort or no symptoms;CT scan for spleen in single or multiple low density or mixed density mass.Hemangioma,wrong structure can show the tumor calcification spots,hamartoma with calcification or fat density.CT enhancement,no enhancement of splenic cyst,hemangioma and delayed enhancement,center filling;lymphangioma without slight strengthening or interval,myofibroblastic tumor or hamartoma to strengthen the characteristic of diversity.6 cases of malignant tumors （3 cases of lymphangioma,2 cases of lymphoma,1 case of malignant fibrous histiocytoma of angiosarcoma）,malignant tumors had abdominal pain,weight loss and other symptoms,CT scan,spleen enlargement,mass was larger,the boundary was not clear,less calcification,can strengthen the CT,tumor metastasis;lymph enhanced slightly,angiosarcoma delayed enhancement,uneven enhancement of malignant fibrous histiocytoma.Conclusion Multi slice spiral CT scanning combined with enhancement has a high diagnostic value for primary splenic tumors.