脾脏硬化性血管瘤样结节性转化的影像学表现及病理对照

The radiological manifestations of sclerosing angiomatoid nodular transformation and pathological comparison

目的:探讨脾脏硬化性血管瘤样结节性转化(sclerosing angiomatoid nodular transformation,SANT)的影像学表现。方法:回顾性分析2015年1月—2020年6月于南京大学医学院附属鼓楼医院就诊的、经手术病理证实的6例SANT患者的资料,总结SANT的影像学表现,并与病理结果对照。结果:6例患者均为单发的类圆形肿块。CT平扫6例均表现为低密度,1例病灶中心出现点状钙化;1例边界欠清、5例边界清楚;CT增强扫描均呈渐近性、向心性、结节样强化。MR平扫表现为T2WI及DWI不均匀等信号或低信号,强化方式与CT类似。4例见"辐轮征"、4例见假包膜、5例见"星芒征"。结论:渐进性、向心性、结节样强化及"辐轮征"、"星芒征"为SANT的特征性影像学表现,尤其以假包膜和T2WI低信号高度提示SANT的诊断。

Objective To discuss the radiological manifestations of sclerosing angiomatoid nodular transformation(SANT).Methods The data of 6 patients with SANT who were admitted to the Drum Tower Hospital Affiliated to the School of Medicine of Nanjing University from January 2015 to June 2020 and confirmed by surgery and pathology were retrospectively analyzed.The imaging findings of SANT were summarized and compared with the pathological results.Results All six cases showed isolated analogous round mass.On CT scans,all cases showed low density,with 1 punctate calcification.5 cases showed clear border.All cases showed progressive,concentric and nodular enhancement.On MR scans,all cases showed isointensity or hypointensity on T2WI and DWI sequences with enhancement patterns similar to CT.4 cases showed“wheels”pattern,4 pseudo capsules and 4“asterisk”signs.Conclusion Progressive,concentric and nodular enhancement,wheels pattern and asterisk signs are characterized radiological manifestations of SANT.Pseudo capsules and hypointensity on T2WI sequence are strong indicators.