摘要
目的探讨脾脏错构瘤(splenic hamartoma,SH)的MRI表现及其病理基础。方法回顾性分析5例经病理证实的SH的MRI影像学资料,结合文献报道总结SH的MRI表现特征及其诊断意义。结果本组5例均为单发病灶,表现为脾内圆形或类圆形结节或团块,最大直径3.5～8.2cm不等。T1WI上呈等或稍低信号3例,呈低信号2例;在T2WI呈高信号1例,稍高信号2例,低信号2例。多期增强动脉期,4例表现为弥漫不均匀轻度强化,1例明显强化。上述5例病灶随时间延迟强化范围扩大,延迟期均接近或稍高于脾实质信号。大体病理显示5例单发病灶均无完整包膜,切面大部分为不均质,呈灰白色、淡红色或暗红色等。组织病理学上,3例病灶成分以红髓为主,混合有少量纤维和淋巴细胞成分,1例主要为红髓成分,1例以纤维成分为主。结论 SH是脾脏少见病,MRI信号特点及强化方式有助于反映病变的病理特征,极少数诊断困难者,最终确诊仍有赖于病理。
Objective To investigate the MRI features of splenic hamartomas （SHs） and its pathologic basis so as to promote the diagnostic accuracy. Methods Five proven cases of SHs underwent MRI scannings and imaging data were analyzed retrospectively. Results These 5 SHs were all appeared as roundish, solid nodules with well-defined margins. MRI showed isointense （n=3） or hypointense signal （n=2） on the T1WI, and heterogeneous bypointense signal （n： 2）, slightly hyperintense signal （n=2） and hyperintense signal （n=1） on the T2WI. On enhanced MRI imagings, 4 cases showed mild diffuse heterogeneous enhancement at early phase, 1 case showed early obvious enhancement, and the abovementioned 5 cases were all demonstrated gradual filling over time. All five SHs presented as unencapsulated spherical or o val shape masses with smooth and well-defined margins. These masses were heterogeneous and with small haemorrhage or cystic change or spotted calcification. 3 cases were composed of red pulp and maxed with a small amount of fibrous component and white pulp. 1 lesion was mainly composed of red pulp and 1 lesion mainly composed of fibrous tissues. Conclusion MRI signal and enhanced features could fully reflect the SHs pathological characteristics and contribute to improve the diagnostic accuracy. When the imaging findings were not typical, a definitive diagnosis is difficult based solely on imaging, and the final diagnosis depends on histopathologic examination.
出处
《医学影像学杂志》
2013年第5期730-733,共4页
Journal of Medical Imaging
关键词
脾脏错构瘤
磁共振成像
病理
Splenic hamartoma
Magnetic resonance imaging
Pathology
