脾肿瘤的CT诊断及鉴别诊断

目的探讨脾肿瘤CT表现和鉴别诊断价值。方法52例脾肿瘤均行CT平扫 增强检查,其中手术及穿刺活检病理证实27例,征象典型及病史明确25例。结果脾良性肿瘤18例,恶性肿瘤34例。良性肿瘤表现为脾脏内单发或多发,多数大小不等低密度结节病变,1例血管瘤为等密度。血管瘤及淋巴管瘤可显示点状或小片状钙化。增强扫描,血管瘤显示延迟均匀强化特点,淋巴管瘤内间隔可轻度强化。脾囊肿无强化。脾脏恶性肿瘤多较大,密度不均匀,增强扫描不均匀强化。脾淋巴瘤表现为脾肿大或多发结节样低密度病变,增强扫描强化不明显。结论CT是诊断脾肿瘤的主要检查方法,结合临床及B超检查,多可做出诊断。

Splenic Neoplasms:CT Diagnosis and Differential Diagnosis

Objective To evaluate the CT value in diagnosis and differential diagnosis of splenic tumors.Methods 52 cases of splenic tumors were examined by plain and contrast-enhanced CT scan.27 cases of splenic tumors were confirmed by operation and pathology,25 cases were definited by clinical history and having typical imaging signs.Results There were 18 benign and 34 malignant tumors.Most of benign splenic tumors appeared as single or multiple low dense nodus with different size,one hemangioma was isodense.Calcifications could be showed in splenic hemangioma and lymphangioma.Homogeneous and marked enhancement occurred in hemangiomas at delayed-phase,no or slightly enhanced in the septum of splenic lymphangiomas,and the cysts had no enhanced.The malignant tumors of spleen were bigger in size mostly with unhomogeneous density,and unhomogeneous enhancement could be seen at contrast-enhanced CT scan.Uneven enlargement of spleen was commonly seen in patients of splenic lymphoma and the lesions were multiple in a most of cases,and had not enhancement obviously.Conclusion Splenic tumors can be diagnosed correctly in most patients based on the features of plain and contrast-enhanced CT in combination with clinical history and the other examinations.