脾脏肿瘤的CT诊断

Diagnosis of Splenic Tumors with CT

目的：详细论述脾脏肿瘤的ＣＴ诊断及鉴别诊断。材料和方法：收集２１例脾脏肿瘤患者的腹部ＣＴ平扫及增强检查资料，分析脾脏大小、轮廓、病灶数目、密度、边界等多种表现。结果：转移瘤的脾脏多为均匀性增大。病灶多发，边界欠清，靶心样强化具特征性。原发性淋巴瘤的脾脏常为不均匀性增大，病灶边界不清，边缘地图样强化具特征性。血管肉瘤绝大多数可发生囊变，增强时囊变区不增强。错构瘤可见钙化、脂肪，具特征性。多发肿瘤以转移瘤及淋巴瘤常见，而单发肿瘤以良性肿瘤多见，少数为转移瘤。结论：尽管脾脏肿瘤性病变较少见，但根据ＣＴ平扫及增强的特征性表现，大多数肿瘤可作出正确诊断。

Emphasis was laid on the diagnosis and differential diagnosis of splenic tumors with CT.Materials and Methods: 21 cases with splenic tumors scanned with plain CT and contrast CT of abdomen were collected. The degree of splenomegaly, contour of spleen, and the number, density,edge of tumor were analysed. Results: In patients with splenic metastases, the spleen were enlarged homogeneously, the tumors were multiple with indefinite edges, and the 'target-like'enhancement was of character, Uneven enlargement of spleen was commonly seen in patients of primary lymphoma, the tumor were multiple with indefinite border, and 'map-like' enhancement of edge was of character, Cystic change was seen in most hemangiosarcoma, and no enhancement in cystic area, Whereas calcification and fat in tumor were the characteristic features in hamartoma.Multiple lesions were commonly seen in metastasis and lymphoma. while single tumor was seen much in benign tumor, and few in metastasis. Conclusion: Splenic tumor was uncommon, but the diagnosis can be made correctly in most patients based on features of plain CT and contrast CT.