脾脏血管性病变与淋巴瘤CT鉴别诊断

目的 运用CT区分脾脏血管性病变与淋巴瘤。方法 回顾性分析20例经手术、穿刺病理学检查证实的脾脏病变的发病年龄、性别、脾脏指数、病变大小、数目、有无液化、钙化、强化幅度、强化方式等特征,并进行统计学分析。结果 20例脾脏病变中,11例血管性病变(6例海绵状血管瘤,3例窦岸细胞血管瘤,2例硬化性血管瘤样结节性转化),9例淋巴瘤;两组间发病年龄、病变大小、数目、有无液化、钙化等差异无统计学意义;两组间脾脏指数、动脉期强化幅度差异具有统计学意义(P＜0.05)。5例海绵状血管瘤呈不均匀性强化,1例呈渐进性填充式强化,2例窦岸细胞血管瘤呈“雀斑征”,1例硬化性血管瘤样结节性转化呈“辐轮征”;9例淋巴瘤实质部分均呈均匀、轻中度强化。结论 脾脏血管性病变与淋巴瘤CT表现不同,CT有助于明确诊断。

CT differential diagnosis of splenic vascular disease and splenic lymphoma

Objective To investigate the difference between CT findings of splenic vascular disease and lymphoma. Methods The age of onset,gender,spleen index,size,number,presence or absence of liquefaction,calcification,enhancement amplitude,enhancement method and other characteristics of 20 cases of splenic lesions confirmed by surgery and puncture pathology were analyzed retrospectively,and statistical analysis was performed. Results Among the 20 cases of splenic lesions,11 cases were vascular lesions (6 cases of cavernous hemangioma,3 cases of littoral cell angiomas,2 cases of sclerosing angiomatoid nodular transformation),and 9 cases of lymphoma.There was no statistical difference between the two groups in age of onset,size,number of lesions,presence or absence of liquefaction,and calcification.The spleen index and arterial phase enhancement amplitude were statistically different between the two groups (P＜0.05).5 cases of cavernous hemangioma showed uneven enhancement,1 case showed progressive filling enhancement,2 cases of littoral cell angiomas showed "freckle sign",and 1 case of sclerosing angiomatoid nodular transformation showed "spoke wheel sign".The parenchymal part of 9 cases of lymphoma showed uniform,mild to moderate enhancement. Conclusion The CT findings of splenic vascular lesions are different from those of lymphoma,and CT can help confirm the diagnosis.