儿童脾脏淋巴管畸形的影像学特征

Imaging Characteristics of Splenic Lymphatic Malformation in Children

[目的]探讨儿童脾脏淋巴管畸形的影像学特征.[方法]回顾性分析本院2010年1月至2020年12月经病理学检查证实的9例脾脏淋巴管畸形患儿的临床资料,8例于本院行CT平扫及增强,1例在外院行CT平扫增强及本院M RI平扫增强.观察并分析脾脏淋巴管畸形的部位、分型、形态、边界、大小、有无钙化、分隔、密度/信号及强化方式等.[结果]3例位于脾脏包膜下,6例位于脾脏周边及深部;病理检查结果显示,4例为巨囊型,3例为微囊型,2例为混合型;3例呈分叶状,6例呈大小不等类圆形;3例边界模糊,6例边界尚清晰,其中1例单发病灶边缘小点条状钙化灶.7例CT平扫呈低密度影,1例呈稍高密度影,微囊型呈"蜂窝状"改变,6例CT增强示分隔及囊壁轻度强化,1例病变中心及边缘稍强化,1例实性部分呈明显不均匀强化,1例病变呈稍长T_(1)稍长T_(2)信号,增强实性部分呈渐进性强化.[结论]儿童脾脏淋巴管畸形呈单发或多发病变,其CT和MRI表现具有一定的特征性,绝大部分呈低密度影或囊性信号,少部分密度或信号不均匀,囊壁可见钙化,其分隔及囊壁轻度强化,实性部分可不均匀强化或渐进性强化,有助于脾脏淋巴管畸形的诊断.

【Objective】Investigate the imaging features of splenic lymphatic malformation in children.【Methods】The clinical data of 9 children with splenic lymphatic malformation confirmed by pathological examination from January 2010 to December 2020 in Hunan Children's Hospital were analyzed retrospectively.Eight patients were performed plain CT scan and enhancement in our hospital,and one patient was performed plain CT scan and enhancement in our hospital.The location,classification,shape,boundary,size,calcification,separation,density/signal and enhancement mode of splenic lymphatic malformation were observed and analyzed.【Results】Three cases were located under the splenic capsule,6 cases were located around and deep in the spleen;Pathological examination showed that 4 cases were giant cysts,3 cases were microcapsules,and 2 cases were mixed;3 cases were lobulated,6 cases were round in size;The boundary of 3 cases was blurred,and the boundary of 6 cases was still clear,including 1 case of single lesion with small point calcification at the edge.On plain CT scan,7 cases showed low density shadow,1 case showed slightly high density shadow,and the microcystic type showed"honeycomb"changes.On enhanced CT scans,6 cases showed slight enhancement of the septum and cyst wall,1 case showed slight enhancement of the center and edge of the lesion,1 case showed obvious uneven enhancement of the solid part,1 case showed slightly longer T_(1) and slightly longer T_(2) signals,and the enhanced solid part showed progressive enhancement.【Conclusion】The splenic lymphatic malformation in children presents single or multiple lesions,and its CT and MRI manifestations have certain characteristics.Most of them present low density shadow or cystic signal,and a few of them have uneven density or signal,calcification can be seen in the cystic wall,and the septa and cystic wall have slight enhancement,while the solid part can have uneven enhancement or progressive enhancement,which is helpful for the diagnosis of splenic lymphatic malformation.