脾脏错构瘤的CT和MRI表现

目的:探讨脾脏错构瘤(SH)的CT和MRI表现.方法:回顾性分析6例病理确诊的SH患者的CT和MRI影像学表现.结果:6例SH中5例为单发,1例为多发.病灶在CT平扫呈等或稍低密度,在T1WI上呈等或稍低信号,在T2WI上呈不均匀低信号(4例)或高信号(2例),其中2例病灶中心出现局灶异常信号.动态增强扫描4例病灶表现为早期弥漫不均匀轻度强化并随时间推移呈渐进性延迟性强化,2例表现为早期均匀较明显强化,2例病灶中心的局灶异常信号呈部分延迟强化.结论:SH的CT和MRI表现具有一定特征性,影像学检查特别是MRI是诊断SH的重要方法.     

脾脏错构瘤的影像学表现分析

目的探讨脾脏错构瘤的影像学特点,提高对本病的诊断水平。方法回顾性分析10例经病理证实的错构瘤的影像学表现。结果本组脾脏错构瘤9例为单发病灶,1例为多发。.肿瘤体积较大,最大直径为4.5cm导致脾脏局部形态失常。CT扫描脾脏错构瘤为等或稍低密度。磁共振扫描肿块在T1WI及T2WI序列为等或稍低。DWI序列以低信号为主。增强扫描,肿瘤多呈明显、持续性强化,延时后与脾脏实质密度或信号相仿。结论脾脏错构瘤的CT及磁共振扫描具有一定的典型性表现,尤其是磁共振T1WI、T2WI及DWI序列并结合增强扫描,可以与其他脾脏病变区别。     

乳腺错构瘤MRI表现

目的 探讨MRI对乳腺错构瘤诊断的价值.方法 收集经手术病理证实的乳腺错构瘤8例,回顾性分析其临床及MRI表现,并复习相关文献.结果 发病年龄42~52岁,平均48岁,病程2 d~15年不等,均为无痛性肿块,其中1例15年来逐渐增大,挤压双乳后有乳汁分泌.8例中椭圆形5例,圆形3例,直径4~10 cm不等.混合型5例,脂肪型2例,致密型1例.MRI表现为T1WI、T2W SPIR高低混杂信号影,即肿块内混杂的成熟脂肪组织和纤维腺体组织,2种成分按不同比例相间分布,边界清,均可见完整的包膜.动态增强后纤维腺体成分呈渐进性强化,强化曲线呈缓慢上升型.结论 明确的脂肪成分与纤维腺体组织不同比例混合的混杂信号及完整的包膜是乳腺错构瘤MRI特征性表现,最后确诊有赖于病理.     

脾脏错构瘤的CT及MRI诊断(附6例报告)

目的 探讨脾脏错构瘤(SH)的CT和MRI特征,以提高对这种罕见病变的认识.方法 搜集经手术病理证实的SH 6例,其中4例同时行CT和MRI检查,单独行CT或MRI检查的各1例,回顾性分析其CT和MRI表现及特点.结果 单发5例,多发1例.CT平扫呈稍低密度4例、等密度1例;MRI成像T1 WI呈低信号1例、等信号4例,T2 WI呈低信号3例、等或高信号各1例.动态增强扫描,表现为早期不均匀轻度强化并随着时间推移呈渐进性延迟强化和早期不均匀明显强化、静脉期持续强化的病灶各3例,延迟期上述病灶均接近或稍高于脾实质密度(信号).结论 SH的CT和MRI表现具有一定的特征性,尤其是MRI的T2 WI,对SH的诊断具有较高的价值.     

脾脏错构瘤影像学表现一例

图1　肝动脉期CT增强扫描,示脾脏中下极类圆形均匀低密度灶　图2　延迟扫描病灶与脾实质呈等密度强化　图3　T1 WI病灶为等信号灶　图4　T2 WI病灶为略低信号灶　图5　延迟扫描病灶信号明显超过脾实质　图6　病理图片。神经纤维由分化良好的细胞构成,细胞呈短梭形,核深染,核仁不明显,胞质淡,嗜酸性,呈栅栏状排列(HE　×10 0 )脾脏错构瘤很少见,笔者报告1例,结合文献进行讨论,以提高对其临床、影像学认识水平。患者　女,4 0岁。体检时B超发现脾脏肿块入院。患者无任何症状、体征。实验室检查:大小便常规及肝肾功能正常。血红蛋白12 5g/L…     

脾脏硬化性血管瘤样结节性转化的MRI表现

目的 探讨脾脏硬化性血管瘤样结节性转化(SANT)的MRI特征.方法 回顾性分析10例经手术病理证实的脾脏SANT患者的MRI资料,总结其影像特征.10例均行MR平扫及多期增强扫描,其中7例行扩散加权成像(DWI)及双回波同反相位磁共振成像(IP/OP).结果 (1)单发9例,均为类圆形肿块,4例(44.4％)见假包膜;T1WI呈等或低信号;T2WI呈不均匀低信号8例(88.9％),不均匀稍高信号1例(11.1％);动态增强扫描均为向心性、渐进性强化,其中辐条轮状强化7例(77.8％),明显结节样强化2例(22.2％),延迟期呈等或高信号,内均见裂隙;7例DWI检查中,低信号6例(85.7％),等信号1例(14.3％);病灶内出血2例(22.2％),均未见坏死囊变.(2)多发1例,表现为脾内弥漫分布的类圆形小结节(＞10个),T1WI均为等信号,T2WI为高信号,增强扫描渐进性强化.结论 单发脾SANT的MRI表现有一定的特征性,特别是病灶周围假包膜有助于本病的诊断;多发SANT与脾脏其他脉管性肿瘤鉴别困难.     

下丘脑错构瘤的CT和MRI诊断

目的：研究下丘脑错构瘤的CT和MRI影像表现,探讨影像学,临床及预后的关系。方法：分析了2例下丘脑错构瘤的CT和MRI资料,其中男1例,女1例,年龄1．5－2岁,1例行CT平扫和增强,另1例行MRI平扫和增强,又作了CT平扫。2例均经手术和病理证实。结果：全部病例临床表现主要为性早熟和痴笑样癫痫,肿块与灰结节或乳头体相连,CT表现为与皮质等密度的不增强肿块,MRI表现在T1WI上与灰质等信号,在PDW和T2WI上等信号或轻度高信号,肿块不增强,结论：如患儿临床上表现为性早熟和痴笑样癫痫,影像学上显示灰结或乳头体肿块,具有典型CT和MRI表现,应首先考虑本病,本病应与颅咽管瘤,下丘脑胶质瘤,生殖细胞瘤鉴别。     

MRI诊断灰结节错构瘤

目的分析灰结节错构瘤的MRI特点及诊断价值。方法回顾性分析经手术病理证实4例灰结节错构瘤的MRI表现,所有病例均行横轴位、冠状位、矢状位三维的MR平扫及增强扫描。结果4例灰结节错构瘤病例MRI都表现为鞍上灰结节处肿块,T1WI和T2WI为等信号,增强扫描病灶无强化。MRI能清晰显示肿瘤的位置及其与邻近解剖结构的关系。结论灰结节错构瘤有特征性的MRI表现,MR可作为一种常规的影像学检查方法对灰结节错构瘤患者进行诊断和追踪。     

脊髓海绵状血管瘤的MRI表现及其病理基础

目的：探讨脊髓海绵状血管瘤的MRI表现特征及其病理基础。方法：对比分析13例脊髓海绵状血管瘤患者术前的MRI表现及其术后病理标本。结果：13例脊髓海绵状血管瘤中，11例位于胸段，2例位于下颈段脊髓内，均为单发，病灶处脊髓增粗9例，萎缩2例，正常2例。病灶呈爆米花状或桑椹状，瘤巢较小，一般不超过脊髓横径。T1WI、T2WI均为混杂信号，且T2WI病灶周围呈低信号环10例，占76．92％；T1WI等信号、T2WI低信号2例，T1WI、T2WI均为高信号1例；增强扫描后，7例病灶中心有中等强化。MRI信号改变与瘤巢反复出血不同时期出血成分沉积及血栓形成、胶质增生密切相关。结论：MRI能反映脊髓海绵状血管瘤的病理变化，对术前确诊具有重要价值。     

软骨母细胞瘤的MRI表现特征及其病理基础

目的 探讨软骨母细胞瘤(chondroblastoma,CB)的MRI表现特点及其病理基础.资料与方法 分析经手术病理证实的13例CB的MRI表现特征,并与病理切片进行对照研究.结果 全部病例在T1WI、T2WI上呈混杂信号.7例病灶边缘在T1WI及T2WI上均可见低信号环.9例有病灶邻近软组织肿胀和(或)关节囊肿胀.8例病灶周围骨髓腔内见水肿带.12例增强扫描均有不均匀明显强化.病理镜下主要由软骨母细胞和大小不等的多核巨细胞组成;7例肿瘤细胞间可见致密粗颗粒状钙盐沉积.6例可见含有暗红色液体囊腔,以及含铁血黄素沉着和组织凝固坏死.结论 CB的MRI表现较具特征性,MRI能反映其病理特性,是诊断CB的重要影像学方法.     

脾脏错构瘤的CT诊断

目的：探讨脾脏错构瘤（SH）的CT诊断价值。方法：回顾性分析9例经病理证实的SH的CT平扫及三期动态增强表现。结果：本组9例中,8例单发病灶,1例多发病灶。单发病灶CT表现：3例平扫呈等密度,4例呈稍低密度（其中2例边缘伴钙化）,1例呈高密度,病灶呈爆米花样钙化。多期增强扫描表现为动脉期弥漫性不均匀轻度强化或周围斑片状强化（6例）,动脉期明显强化（1例）,延迟后上述病灶均接近或稍高于脾实质密度。1例爆米花样钙化各期均未见强化;本组1例多发病灶者共发现8个病灶,最大径1.2～9.5cm不等,CT显示脾上极1个病灶以囊性为主,边缘弧形钙化。其余病灶为实性结节或肿块,以等低密度为主,边界欠清,增强后呈弥漫性、渐进性强化。结论：SH的CT表现有一定特征,当CT平扫显示脾内等或稍低密度实性肿块,伴或不伴钙化,多期增强扫描动脉期病灶呈弥漫性不均匀轻度强化或周围斑片状强化,随时间延迟呈渐进性强化,延迟期接近或稍高于脾实质密度时有助于SH的诊断。     

CT- and computer-based features of small hamartomas

Purpose

To identify characteristic computed tomographic (CT) and computer-derived features of hamartomas manifesting as small pulmonary nodules.

Methods

Individuals with a diagnosis of hamartoma were identified among participants in the International Early Lung Cancer Action Program and were included if there thin section CT images that included the entire nodule. The CT findings were reviewed to determine the nodule consistency (solid, part-solid, nonsolid), nodule diameter (average of length and width), shape (round, lobulated, neither) and edge (smooth, not smooth). Computer measures of nodule compactness, sphericity, surface regularity and gradient (change in gray-scale between the nodule and the surrounding parenchyma) were determined. Volume doubling time (VDT) was also determined for those with at least two scans with similar imaging acquisitions.

Results

A total of 21 cases of hamartomas that had histologic or cytologic confirmation were identified. The median age was 60 and 12 (57%) were men. Average diameter was 10.7 mm (5-20.7 mm). All were solid in consistency and were described by the radiologist as having either round or lobulated shape with a smooth edge. None had pathognomonic radiologic findings for hamartoma. Computer measures demonstrated that all were compact and spherical, with a regular surface and a sharp margin between the nodule and surrounding parenchyma. Of nine on whom the VDT could be calculated, eight had VDTs longer than 450 days.

Conclusion

Both radiologist and computer derived features of small hamartomas suggest a consistent presentation for these lesions which may be helpful in distinguishing them from other types of nodules.     

MRI features of focal splenic lesions in patients with disseminated tuberculosis

OBJECTIVE: The aim of this study is to describe the MRI features of focal splenic lesions in patients with disseminated tuberculosis. CONCLUSION: Tuberculous focal splenic lesions are small, multiple, and most often associated with splenomegaly. Signal intensities vary on both T1- and T2-weighted images. Two different enhancement patterns are noted: peripheral enhancement and gradual peripheral enhancement with complete fill-in.     

心肌淀粉样变性的临床表现及MRI特征

目的 探讨心肌淀粉样变性临床表现及MRI特征.方法 回顾性分析5例经组织病理检查确诊的心肌淀粉样变性患者,其中3例经心脏移植,2例经心内膜活检证实.5例患者均经心电图、X线胸片、超声心动图和MR检查.结果 5例均确诊为心肌淀粉样变性,男女比例为4∶1,5例患者均有心电图异常;X线胸片3例有肺淤血,5例心脏增大,3例伴有少至中、大量胸腔积液;超声心动图示心房扩大,左心室壁肥厚,心室舒张受限,部分出现心肌回声增强;MRI表现为左心室壁普遍增厚,但以室间隔增厚为主,左心室射血分数32.5%±15.0%,限制性心室舒张期充盈受限;延迟增强MRI 4例表现为全心心内膜下为主的弥漫性粉尘样强化,同时累及乳头肌,其中3例患者室间隔左、右心室壁心内膜下均出现强化,在室间隔形成"斑马征",1例表现左心室透壁性强化,自内向外强化程度渐弱.结论 MRI"一站式"扫描能够全面显示心肌淀粉样变性心脏结构和功能变化,心肌弥漫性粉尘样强化和"斑马征",在心肌淀粉样变性诊断中具有很高的参考价值.     

Multiple biliary hamartomas: magnetic resonance features with histopathologic correlation

The purpose of this study was to report the magnetic resonance imaging (MRI) features of multiple biliary hamartoma (MBH) and to correlate them with histopathology. MRI features of 11 patients with MBH proven by histology were retrospectively reviewed and correlated to histopathology. MBH presented as multiple, tiny, and uniformly distributed lesions in all cases. All were hypointense on T1-weighted images and hyperintense on T2-weighted images relative to the liver parenchyma. Mural nodules were identified in 10 of 11 (91%) cases. They were isosignal on T1-weighted images, intermediate signal on T2-weighted images. Gadolinium-enhanced images showed mural nodule enhancement in 9 of 10 patients (90%) or a peripheral rim-like enhancement of the whole lesion in one case (9%). MBH were present in all liver specimens. In the six patients examined at MR cholangiography, the lesions lacked communication with the biliary tree. At histopathology, the mural nodule corresponded to an endocystic polypoid projection made of conjunctive septa. Three (27%) patients had associated focal nodular hyperplasia, and 1 (9%) had concomitant cholangiocarcinoma. MRI features allowed diagnosis of MBH with accuracy. Their recognition, especially the mural nodule, may help avoid misdiagnosis.     

三阴性乳腺癌MRI征象与临床病理特征的研究现状

三阴性乳腺癌指雌激素受体、孕激素受体和人表皮生长因子受体2均表达阴性的乳腺癌。该型乳腺癌具有特殊的生物学行为和临床病理特征,侵袭性强,缺乏有效的内分泌治疗和靶向治疗,是乳腺癌分子亚型中预后最差的一种。MRI是目前诊断乳腺癌最有价值的检查方法之一。MRI表现为肿块型单一病灶．形状不规则．边缘光滑,呈环形强化,T2WI上病变中心呈高信号,表现为Ⅲ型时间一信号强度曲线以及较高的ADC值,对诊断三阴性乳腺癌有一定的参考价值。     

Fibrous splenic hamartoma: imaging features

Splenoma or splenic hamartoma is a rare primary splenic tumor most often incidentally discovered. The authors report the case of a splenic hamartoma, developed in an asymptomatic man and imaged by US, CT and MRI. This tumor which measured 7 cm in diameter, was hypoechoic with posterior hardening of the ultrasound beam, and not much vascularized as demonstrated by Duplex and color Doppler examination. The tumor MR imaging showed hyperintensity on T1-weighted and hypointensity on T2-weighted. The final diagnosis was not established until the histologic examination of the splenectomy specimen was performed. Histopathologically, the tumor corresponded to a fibrous type of splenic hamartoma. The atypical imaging features which led to splenectomy were probably related to the fibrous component of the hamartoma.     

脾脏窦岸细胞血管瘤的影像表现

目的 探讨脾脏窦岸细胞血管瘤的影像特征.方法 回顾性分析10例经手术病理证实的脾脏窦岸细胞血管瘤患者的CT及MRI表现及临床资料,总结其影像表现特征.结果 10例脾脏窦岸细胞血管瘤中,9例临床上表现为脾脏肿大和(或)脾功能亢进.影像上表现为多发结节,大小不等.MR T2WI及DWI上病灶多呈高信号.CT和MR平扫病灶不易显示;病灶对比增强扫描明显强化,强化方式为向心性强化,延迟期病灶不易显示,观察瘤灶数目最佳时期是对比增强扫描的门静脉期.结论 脾脏窦岸细胞血管瘤的CT及MRI表现具有一定特征性,尤其是DWI表现,可为窦岸细胞血管瘤的鉴别诊治提供帮助.