脾脏硬化性血管瘤样结节性转化的CT、MRI表现

目的 探讨脾脏硬化性血管瘤样结节性转化（sclerosing angiomatoid nodular transformation,SANT）的影像学特征,提高对脾脏SANT的术前诊断水平。方法 回顾性收集并分析经手术病理证实的7例脾脏SANT患者的临床及影像学资料,分析患者临床特点、病理基础及CT和（或）磁共振成像（magnetic resonance imaging,MRI）的特征表现。结果 7例脾脏SANT患者中女性4例,男性3例,患者年龄28~62岁,中位年龄50岁。病理学特征为纤维硬化间质中形成多个血管瘤样结节。病灶在MRI的T₂-weighted imaging （T₂WI）及增强扫描动脉期表现为"轮辐征",增强扫描5min延迟期中心区域见星芒状延迟强化。病灶在CT上表现为动脉期周边结节样强化及后期渐进性强化,强化特点与MRI增强类似,但因延迟时间不够,中心纤维延迟强化的特点不明显。结论 脾脏SANT的典型MRI征象包括在T₂WI及动脉期的"轮辐征",以及延迟期的中心星芒状纤维组织延迟强化。MRI对脾脏SANT基本征象的显示优于CT。

CT and MRI Radiologic Characteristics of Sclerosing Angiomatoid Nodular Transformation

Objective To retrospectively analyze the magnetic resonance imaging (MRI) and CT characteristics of Sclerosing angiomatoid nodular transformation (SANT), to improve the level of preoperative diagnosis of splenic SANT. Methods We retrospectively collected and analyzed the clinical,pathologic and radiologic imaging data of 7 cases of patients with spleen SANT confirmed by surgical pathology, including the clinical history, CT and/or(Magnetic resonance imaging, MRI) manifestation. Results Four cases of spleen SANT were female, 3 cases were male. Their ages ranged from 28 to 62 years; the median age was 50 years. Pathological features were the formation of multiple angiomatous nodules in the interstitial tissue of fibrous sclerosis. The lesions presented "spoke wheel pattern" on both arterial phase and T₂-weighted imaging (T₂WI), as well as scar-like delay enhancement in center area on delay phase 5 minutes after contrast media injection. The lesions on CT showed peripheral nodular enhancement on arterial phase and progressive enhancement on delay phase. The enhancement characteristics were similar to those on MRI enhancement. However, because of relatively short delayed time, the central fiber delayed enhancement was not obvious compared to MRI. Conclusion The typical MRI manifestations of spleen SANT include "spoke wheel pattern" on T₂WI and arterial phase, as well as scar-like delay enhancement in center area on delay phase. MRI showed superiority to CT for spleen SANT in presenting basic signs.