脾种植的CT和MRI表现

发布时间：2018-05-30 19:43

本文选题：脾种植 + 磁共振成像　；参考：《临床放射学杂志》2015年05期

【摘要】：目的探讨脾种植的CT和MRI特征性表现。方法回顾性分析7例腹部脾种植患者的CT和MRI表现并与病理结果进行对照。结果 7例患者均有脾外伤破裂或脾切除史,有19个脾种植结节,呈圆形或卵圆形。(1)1例脾种植位于腹膜后,1例2个病灶分别位于脾区和胰腺尾部,3例位于脾区。上述5例脾种植直径10~50mm。螺旋CT扫描2例,平扫表现为稍低密度,增强扫描动脉期、门静脉期及延迟期均为均匀稍高密度。MRI平扫5例,2例T1WI正相位均为等信号,T1WI反相位信号降低;3例T1WI正相位为稍低信号、T1WI反相位信号无明显降低。T2WI均为中高信号。MRI增强扫描1例,动脉期、门静脉期和延迟期均为高信号。病理检查脾种植内无或少量含铁血黄素。(2)1例多发脾种植患者,5个病灶位于肝脏,7个病灶位于上腹部大网膜和肠系膜区;1例脾种植位于脾区;上述2例脾种植直径10~40 mm,2例同时行CT和MR扫描。CT平扫1例为略高密度(脂肪肝背景),1例为均匀低密度;增强扫描动脉期、门静脉期和延迟期均为高密度。MR平扫,T1WI 2例均为稍低信号,T1WI反相位1例信号无降低,1例信号降低;T2WI 2例均为不均匀低信号。增强扫描1例动脉期和门静脉期肝脏病灶呈轻度高信号,延迟期呈低信号;大网肠和肠系膜病灶动脉期、门静脉期和延迟期均呈中等高信号。1例脾区脾种植动脉期、门静脉期和延迟期均呈低信号。病理检查病灶内见大量含铁血黄素。结论脾种植的CT和MRI表现有一定特征性,能准确反映其病理学基础。
[Abstract]:Objective to investigate the CT and MRI features of splenic implants. Methods CT and MRI findings of 7 patients with abdominal splenic implants were retrospectively analyzed and compared with pathological findings. Results all of the 7 patients had a history of splenic trauma rupture or splenectomy. There were 19 splenic implanted nodules, which were round or oval. One patient with splenic implants was located in the retroperitoneal region. One patient with 2 lesions was located in the splenic region and 3 patients with the pancreatic caudal region were located in the splenic region. The diameter of splenic implants in the above 5 cases was 10 ~ 50 mm. Spiral CT scan was performed in 2 cases, with low density and enhanced arterial phase. Portal phase and delayed phase were homogeneous and slightly high density. Plain scan in 5 cases and T1WI positive phase in 2 cases. All of them were equal signal intensity T 1WI inverse phase signal decrease. 3 cases T1WI positive phase was slightly low signal intensity T 1WI inverse phase signal did not decrease obviously. T2WI was medium and high signal intensity. MRI enhanced scan in 1 case. The arterial phase, portal vein phase and delayed phase were all hyperintense. Pathological examination showed that there was no or little hemosiderin in splenic implants in 1 patient with multiple splenic implants, 5 lesions were located in the liver, 7 lesions were located in the superior abdominal omentum and mesenteric region, 1 case was located in the splenic region. Both CT and Mr scans were performed in 2 cases with splenic implant diameter of 1040 mm and 1 case with slightly high density (1 case with fatty liver background: 1 case with homogeneous low density, 1 case with enhanced arterial phase, 1 case with homogenous low density, 1 case with fatty liver background), and 2 cases with splenic implantation diameter 1040 mm / mm respectively. Both portal phase and delayed phase were high density. Mr plain scan T 1WI in 2 cases were both slightly low signal intensity and low signal intensity on T 1WI in 1 case, no decrease of signal intensity on T 1WI in 1 case, signal lowering on T 2WI in 2 cases were all heterogeneous and low signal intensity. Contrast enhanced scanning showed slight hyperintensity in hepatic lesions in arterial phase and portal phase, low signal in delayed phase, arterial phase in large reticulum and mesenteric lesions, moderate high signal in portal phase and delayed phase in 1 cases of splenic region splenic implants artery phase. Both portal vein phase and delayed phase showed low signal intensity. Histopathological examination showed a large amount of hemosiderin in the lesion. Conclusion CT and MRI findings of splenic implants have some characteristics and can accurately reflect the pathological basis of splenic implants.
【作者单位】：郑州人民医院影像科;
【分类号】：R445.2;R657.6;R816.5

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