脾脏窦岸细胞血管瘤的MDCT/MRI特征分析

Analysis of MDCT/MRI features of littoral cell angioma in spleen

目的探讨脾脏窦岸细胞血管瘤(littoral cell angioma,LCA)的MDCT/MRI表现,提高对此类肿瘤的术前诊断水平。方法回顾性分析浙江中医药大学附属嘉兴市中医医院2008年1月至2019年8月经手术病理证实的9例LCA患者的临床资料及影像学表现,总结LCA影像学特点。结果 9例LCA中,脾脏体积肿大或局部肿大8例;肿块呈类圆形,表现为单发病灶3例,多发病灶6例,所有病灶最大直径(2.6±1.7)cm。MDCT平扫呈等或稍低密度,边界不清5例,增强扫描病灶迅速廓清,部分病灶边缘呈"环状"强化4例,静脉期及延迟期呈"填湖样"渐进性强化。MRI T1WI呈等稍低信号、T2WI呈稍高信号,增强扫描2例单发肿块呈"快进慢出"延迟强化的特性且三期强化程度均高于脾脏。结论 LCA的MDCT及MRI表现有肿瘤局部外凸、假包膜及"雀斑"征,增强扫描对于LCA的术前诊断具有较高价值。

Objective To investigate the MDCT and MRI imaging characteristics of littoral cell angiomas(LCA)in spleen,and to improve the preoperative diagnosis.Methods Clinical data and imaging findings of 9 patients with LCA in spleen confirmed by operation and pathology in Jiaxing Hospital of Traditional Chinese Medicine from Jan.2008 to Aug.2019 were retrospectively analyzed.Results Among the 9 cases,splenomegaly or local enlargement were found in 8 cases.The masses were round in shape,showing single lesion in 3 cases and multiple lesions in 6 cases.The mean maximum diameter of all the lesions was(2.6±1.7)cm.MDCT showed equal or slightly low density and unclear boundary in 5 cases.On enhanced scan,the lesions were clearly seen,some lesions showed“ring”enhancement in 4 cases,with slow progressive enhancement(lake filling signs)in venous phase and delayed phase.MRI showed slightly hypointense on T1WI and slightly hyperintense on T2WI.On contrast-enhanced scan,2 cases showed delayed enhancement of“fast in and slow out”,and the degree of three-phase enhancement was higher than that of spleen.Conclusion MDCT and MRI features of LCA in spleen pseudocapsule and“freckle”sign.In particular,enhanced scan is of high value for preoperative diagnosis of LCA in spleen.