脾脏炎性假瘤的影像学表现（附三例报告）

目的 报道3例脾脏炎性假瘤的影像学表现，以提高对本病的认识。方法 复习3例脾脏炎性假瘤的超声、CT扫描和1例MRI表现，并与病理表现进行对照。结果 B超表现为单发球形病变，回声不均匀、边界清楚，其中1例见环状强回声伴后方声影。3例CT平扫见脾内边界清楚的低密度肿块，1例见周边蛋壳样环状钙化；2例作增强扫描，1例静脉期略有增强，另1例延迟扫描病变强化程度与脾实质接近；1例又作MR平扫，T1、T2WI均以低信号为主。结论 脾脏炎性假瘤应列入脾单发肿物的鉴别诊断，其影像表现与肿块内纤维组织和炎性肉芽组织的多少有关。超声表现为边界清楚、回声不均的肿块；CT增强扫描以病变延迟强化为特点；MRT2WI常以低信号为主。

Imaging appearances of inflammatory pseudotumors of the spleen (report of 3 cases)

Objective To improve the recognition of the imaging appearances of inflammatory pseudotumors of the spleen (IPS), 3 cases with IPS were reported. Methods The US (n=3), CT (n=3) and MRI (n=1) findings of IPS were reviewed and correlated with the pathologic findings. Results On US, a well-defined solitary mass with heterogeneous echo texture was found in all 3 cases. A hyperechoic rim with associated acoustic shadowing was shown in 1 case. In all of the 3 cases in nonenhanced CT scanning, a well-defined hypoattenuated mass was found. One had a calcified egg-shell-like rim; On the venous/delayed phase of enhanced CT after contrast administration in 2 cases, slight/marked enhancement was shown. On nonenhanced MRI in 1 case, the mass was shown as heterogeneous hypointensity on T 1- and T 2- weighted images. Conclusion IPS should be included in the differented diagnosis of solitary mass lesion of spleen. The imaging findings depend on the variable proportions of fibrous and granulomatous components within the lesion. IPS was characterized by well-defined solitary mass on sonogram, delayed enhancement on enhanced CT, and hypointensity on T 2 weighted MR images.