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脾脏肿瘤CT、MRI诊断

作者:陆永文1 谢婷婷2 王成林2

所属单位:1.广东省深圳市博爱医院影像科(广东 深圳 518022) 2.北京大学深圳医院医学影像中心(广东 深圳 518036)

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摘要

目的探讨脾肿瘤CT、MRI影像表 现,提高脾肿瘤良、恶性的诊断水平。 材料和方法 回顾分析30例经手术、穿刺 病理证实或已明确诊断的脾脏肿瘤临床及 影像学表现。结果 良性脾肿瘤13例,恶 性脾肿瘤17例。良性肿瘤以血管瘤、脾囊 肿、脾脓肿多见;脾血管瘤多表现为多囊 性或实性占位,增强后不均匀强化、随 扫描时间延续强化向病灶中心填充,MR 扫描T2WI具有典型的“灯泡”征;脾囊 肿常见于外伤后,呈囊性占位,增强后无 强化。脾脏恶性肿瘤以淋巴瘤、转移瘤多 见;脾淋巴瘤患者,脾脏可均匀肿大或大 小正常,可有多发实性结节或孤立的不均 质肿块,增强扫描强化不均匀。转移瘤不 多见,继发于恶性肿瘤血行播散,呈多发 大小不等结节。结论 认真分析脾脏肿瘤 CT、MRI表现,有助于提高脾脏肿瘤诊断 的准确率。

Objective To investigate the CT and MRI manifestations in splenic tumors, and improve the diagnostic accuracy rate of benign and malignant splenic tumor. Materials and Methods The CT and MRI scan data of 30 cases of splenic tumors with surgicalpathological proved splenic tumor were analyzed retrospectively. Results A total of 13 cases were benign tumor, 17 cases were malignant tumor. Splenic cavernous hemangioma, spenic cyst and splenic abscess were most common benign tumor in the spleen; splenic cavernous hemangioma showed multiple cystic lesions or solid lesion, and has local prominency in inner margin of spleen, and enhanced most depply. The typical cavernous hemangioma showed "lump bulb" sign on MR imaging. Spenic cyst were cystic lesions and mostly occured after injury, has no enhancement. Splenic lymphoma and metastatic tumor were the most common splenic malignant tumor. Splenomegaly, multiple nodular lesions or isolated inhomogeneous lesion could be seen in splenic lymphoma patients, and had inhomogeneous enhancement after enhanced. Splenic metastatic tumor were rare, showed multiple lesions in the spleen, and mostly secondary to the hematogenous spread of malignant tumor. Conclusion Serious analyze the CT and MRI manifestations in splenic tumors helps to improve the diagnostic accuracy rate of benign and malignant splenic tumor.

【关键词】脾脏;肿瘤;诊断;CT;MRI

【中图分类号】R73; R44

【文献标识码】A

【DOI】 10.3969/j.issn.1672-5131.2015.04.25

前言

脾脏肿瘤少见,随着CT、MRI技术的发展,脾肿瘤的检出率不断提 高[2],为提高对脾脏肿瘤的确诊率,我们将2006年6月~2014年6月间 经CT和MRI检查、并经手术、穿刺活检病理证实的30例脾脏肿瘤影像学 资料进行回顾性分析。