CT and MRI features of sclerosing angiomatoid nodular transformation of the spleen: A report of 18 patients with pathologic correlation |
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| Authors: | Jianyong Liao Zhanbo Wang Qiong Li Zhenheng Gou Xu Bai Huanhuan Kang Huaiyin Shi Haiyi Wang |
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| Affiliation: | 1. Department of Radiology, Daxing Teaching Hospital of Capital Medical University, No. 26 Huangcunxi Street, Daxing District, 102600 Beijing, China;2. Department of Pathology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853 Beijing, China;3. Department of Radiology, Tianjin Nankai Hospital, No. 6 Changjiang Road, Nankai District, 300100 Tianjin, China;4. Department of Radiology, Fifth Medical Center, Chinese PLA General Hospital, No. 100 West Fourth Ring Middle Road, Fengtai District, 100039 Beijing, China;5. Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853 Beijing, China |
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| Abstract: | PurposeThe purpose of this study was to describe the computed tomography (CT) and magnetic resonance imaging (MRI) features of sclerosing angiomatoid nodular transformation (SANT) of the spleen and correlate imaging features with those obtained at histopathologic analysis.Materials and methodsA total of 18 patients (9 men, 9 women; mean age, 42.2 ± 10.7 [standard deviation (SD)] years; range, 23–59 years) with histopathologically confirmed SANT were retrospectively evaluated. The presenting symptoms, gross pathologic changes, and histopathologic and correlative immunohistochemical results were recorded. CT (n = 8) and MRI (n = 12) features were analyzed by two radiologists and included number, size, shape, boundary, attenuation, signal intensity, and enhancement patterns.ResultsSeventeen patients (17/18; 94%) had a single SANT without specific clinical symptoms and one patient (1/18; 6%) had multiple SANTs with left-upper-quadrant bloating and pain. The largest lesion diameter exceeded 3 cm. On plain CT images, SANTs were slightly hypoattenuating in seven patients (7/8; 88%), isoattenuating in one patient (1/8; 13%), and contained calcification in two patients (2/8; 25%). On T2-weighted MR images, SANTs displayed hypointensity in ten patients (10/12; 83.3%), isointensity in one patient (1/12; 8%) and hyperintensity in one patient (1/12; 8%). On T2-weighted images, stellate or scattered fibrous scars were observed in all patients (12/12; 100%). On diffusion-weighted images, SANTs appeared as heterogenous or homogeneous hypointense in 12 patients (12/12; 100%). Compared to out-of-phase images, SANTs displayed decreased local signal intensity on in-phase images in 12 patients (12/12; 100%). On enhanced CT and MRI images, SANTs had clear boundaries (17/18; 94%), oval (7/18; 39%) or lobular (7/18; 39%) shape, displayed progressive centripetal enhancement (18/18; 100%), spoke-wheel pattern (14/18; 78%), nodular enhancement (11/18; 61%), or delayed enhancement of central fibrous scar (9/18; 50%).ConclusionsSANT of the spleen predominantly manifests as a solid, single, oval or lobular, and well-defined lesion with a fibrous scar and occasional calcification. Typical enhancement characteristics include progressive and centripetal enhancement, spoke-wheel pattern, nodular enhancement, and delayed enhancement of central fibrous scar. Hypointensity on T2- and diffusion-weighted images are due to hemosiderin deposition and fibrous tissue. |
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| Keywords: | Magnetic resonance imaging (MRI) Neoplasms Spleen Sclerosing angiomatoid nodular transformation (SANT) Tomography, X-ray computed 3D-VIBE" },{" #name" :" keyword" ," $" :{" id" :" kw0035" }," $$" :[{" #name" :" text" ," _" :" three-dimensional volumetric interpolated breath-hold examination CT" },{" #name" :" keyword" ," $" :{" id" :" kw0045" }," $$" :[{" #name" :" text" ," _" :" computed tomography DWI" },{" #name" :" keyword" ," $" :{" id" :" kw0055" }," $$" :[{" #name" :" text" ," _" :" diffusion-weighted imaging FOV" },{" #name" :" keyword" ," $" :{" id" :" kw0065" }," $$" :[{" #name" :" text" ," _" :" field of view H&E" },{" #name" :" keyword" ," $" :{" id" :" kw0075" }," $$" :[{" #name" :" text" ," _" :" hematoxylin-eosin MRI" },{" #name" :" keyword" ," $" :{" id" :" kw0085" }," $$" :[{" #name" :" text" ," _" :" magnetic resonance imaging SANT" },{" #name" :" keyword" ," $" :{" id" :" kw0095" }," $$" :[{" #name" :" text" ," _" :" sclerosing angiomatoid nodular transformation SD" },{" #name" :" keyword" ," $" :{" id" :" kw0105" }," $$" :[{" #name" :" text" ," _" :" standard deviation SMA" },{" #name" :" keyword" ," $" :{" id" :" kw0115" }," $$" :[{" #name" :" text" ," _" :" smooth muscle actin TE" },{" #name" :" keyword" ," $" :{" id" :" kw0125" }," $$" :[{" #name" :" text" ," _" :" echo time TR" },{" #name" :" keyword" ," $" :{" id" :" kw0135" }," $$" :[{" #name" :" text" ," _" :" repetition time T1WI" },{" #name" :" keyword" ," $" :{" id" :" kw0145" }," $$" :[{" #name" :" text" ," _" :" T1-weighted imaging T2WI" },{" #name" :" keyword" ," $" :{" id" :" kw0155" }," $$" :[{" #name" :" text" ," _" :" T2-weighted imaging |
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