脾脏肿瘤 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30例脾肿瘤（良性13例，恶性17例）均行CT 平扫＋增强检查，其中手术及穿刺活检病理证实18例，征象典型及病史明确16例。结果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。脾错构瘤的钙化和脂肪组织肿块为其特征性表现。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，CT 多可作出病因学诊断。

CT Diagnosis and Differential Diagnosis of Splenic Noeplasmas

Objective To exPlore the value of CT diagnosis and differential diagnosis of sPlenic tumors. Methods 30 Patients with sPlenic tumors（13 were benign and 17 were malignant）were examined by CT Plain and enhanced scanning. 18 Patients were confirmed by oPeration and Pathology,16 were diagnosed by tyPical signs and definite histo-ry. Results Single or multiPle low density nodular lesions were manifested in benign tumors,and 1 hemangioma was isodense. Punctate or flake calcifications could be shown in hemangioma and lymPhangioma. Homogeneous and marked enhancement occurred in hemangiomas at delayedPhase,mild enhancement occurred in lymPhangioma in the interval, and no enhancement occurred in sPlenic cyst. Calcification of sPlenic hamartoma and adiPose tissue mass were charac-teristic manifestations. Malignant tumors of sPleen were mostly large of uneven density with heterogeneous density. SPlenomegaly and multiPle low density nodular lesions were manifested in sPlenic lymPhoma with unobvious enhance-ment. Conclusion CT is the main examination method in the diagnosis of sPlenic neoPlasmas,which can make etio-logical diagnosis combined with clinical history and B - ultrasound examination.