摘要
目的 分析脾种植的CT、MRI影像 学特点。方法 回顾性分析我院收治的20 例腹部脾种植患者的临床资料,患者均接 受CT与MRI检查,总结其CT、MRI表现,与 病理结果对照。结果 20例脾种植患者,4 例位于腹膜后侧,10例位于脾脏,3例位 于脾区、胰腺尾部,2例多发脾种植中, 14个病灶位于上腹部肠系膜、大网膜区, 10个病灶位于肝脏,呈圆形或类圆形,最 大直径1.0cm-5.0cm,边缘清晰;CT平扫 见稍低密度灶,边缘清晰,增强扫描强化 均匀;MRI平扫T1WI序列正相位呈等或稍 低信号,反相位信号降低或无变化,T2WI 序列均呈等信号、高信号,肝脏脾种植区 可见带状等信号,增强扫描动脉期、静脉 期均可见非均匀稍高信号,延迟期呈低信 号,包膜延迟期呈高信号,肝脏内带状影 呈高信号,肠系膜、大网膜三期扫描均呈 中等高信号。结论 CT、MRI影像学可作为 脾种植诊断的辅助手段,其影像学变化与 脾种植病理特点有较强的联系,但对部分 影像学无特异性征象的脾种植者,则可配 合穿刺活检、核素检查。
Objective To analyze the imaging features of CT and MRI in spleen implantation. Methods The clinical data of 20 patients who underwent abdominal spleen implantation in our hospital were analyzed retrospectively. All patients underwent CT and MRI examination. The CT and MRI findings were summarized and compared with the pathological findings. Results Among the 20 patients with spleen implantation, 4 cases were located in the posterior part of peritoneum, 10 in spleen, 3 cases in spleen and pancreatic tail and 2 cases in multiple spleen implantation. 14 lesions were located in upper abdominal mesenterium and greater omentum area, 10 lesions in the liver, round or quasi-circular and the largest diameter was 1.0cm-5.0cm. The edges were clear; CT plain scan showed slightly low density lesions, compared with normal spleen tissues and the edges were clear. The enhancement at the three phases was homogeneous; MRI scan showed equal or slightly low signal on T1WI sequence positive phase and the antiphase signal decreased or did not change. There were equal signal and high signal on T2WI sequence and banding equal signal in spleen implantation region. Enhanced scan showed inhomogeneous slightly high signal in arterial phase and venous phase, low signal in delayed phase, high signal in envelop delayed phase, high signal in banding shadow in liver. Three-phase scan showed middle high signal in mesenterium and greater omentum. Conclusion CT and MRI imaging can be used as a supplementary means for diagnosis of spleen implantation. The imaging changes and pathological findings of spleen implantation are significantly associated but for some patients whose imaging findings are not specific, biopsy and nuclein examination can be adopted.
【关键词】脾种植;CT;MRI;特点
【中图分类号】R322.2+1
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.06.025
前言
脾种植多由外伤或其他原因所致脾切除术后散落脾组织细胞团在 脏器官表层重新建立血液循环,并生长为具包膜大小非均匀结节,临 床少见,易误诊为恶性肿瘤[1]。脾种植概念最早由国外学者提出,后 有研究陆续有报道外伤后脾种植病例,多为个案分析,少见影像学研 究报道[2]。因此,为探讨脾种植的CT及MRI影像学特点,降低误诊,我 院对收治的20例脾种植患者的临床资料进行了回顾性分析,现总结如 下。
中国CT和MRI杂志
第14卷, 第 6 期
2016年06月
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