【摘要】：目的探討孤立型脾臟單發(fā)淋巴管瘤的CT影像特點(diǎn)與病理類型間的關(guān)系,加強(qiáng)對(duì)本病的認(rèn)識(shí),提高診斷水平。方法搜集本院經(jīng)手術(shù)病理證實(shí)的孤立型脾臟單發(fā)淋巴管瘤10例,回顧性分析患者的臨床、CT影像及病理資料,CT平掃10例,增強(qiáng)掃描9例。結(jié)果本組10例中,男4例,女6例,年齡32~79歲,平均53.4歲,其中8例無任何臨床癥狀,由B超體檢發(fā)現(xiàn),僅2例有與脾臟增大相關(guān)的輕微臨床癥狀。10例均為單發(fā),共10個(gè)病灶,直徑3.2~6.6 cm,CT平掃所有病灶均為囊性低密度灶,境界清楚8例,不清楚2例,其中形態(tài)不規(guī)則呈分葉狀、密度不均、內(nèi)見粗細(xì)不均分隔的病灶有6例,增強(qiáng)后病灶囊壁較薄,囊壁及分隔輕~中度強(qiáng)化,囊內(nèi)容物除分隔外均無強(qiáng)化,病理均診斷為海綿狀淋巴管瘤,另外4例形態(tài)規(guī)則呈類圓形、密度均勻、內(nèi)無分隔的病灶,增強(qiáng)后病灶囊壁較薄,囊壁輕~中度強(qiáng)化,囊內(nèi)容物密度均勻、均無強(qiáng)化,病理均診斷為囊狀淋巴管瘤。10例中誤診為脾臟囊腫1例。結(jié)論孤立型脾臟單發(fā)淋巴管瘤少見,成年人發(fā)病率明顯高于兒童,患者臨床上無明顯癥狀或癥狀輕微,病程較長(zhǎng),進(jìn)展緩慢,其CT影像特點(diǎn)與病理類型有關(guān),海綿狀淋巴管瘤CT平掃病灶形態(tài)多不規(guī)則,呈分葉狀,密度不均,內(nèi)見粗細(xì)不均的分隔,增強(qiáng)后囊壁及分隔輕~中度強(qiáng)化,囊內(nèi)容物除分隔外無強(qiáng)化;囊狀淋巴管瘤CT平掃病灶形態(tài)較規(guī)則,呈類圓形,密度均勻,內(nèi)無分隔,增強(qiáng)后病灶囊壁較薄,囊壁輕~中度強(qiáng)化,囊內(nèi)容物無強(qiáng)化、密度均勻。
[Abstract]:Objective to investigate the relationship between CT imaging features and pathological types of solitary lymphangioma of the spleen, to enhance the understanding of the disease and improve the diagnostic level. Methods Ten cases of solitary lymphangioma of spleen proved by operation and pathology were collected. The clinical CT images and pathological data of 10 cases were retrospectively analyzed. Results there were 4 males and 6 females, aged 32 to 79 years (mean 53.4 years). Among them, 8 cases had no clinical symptoms. Only 2 cases had mild clinical symptoms associated with splenomegaly and 10 cases had 10 lesions. All the lesions were cystic low-density lesions with a diameter of 3.2 ~ 6.6 cm ~ (-1). The boundary was clear in 8 cases and unclear in 2 cases. The shape of the lesions was irregular in lobular shape and uneven in density. There were 6 lesions in which the thickness was uneven and the thickness was uneven, and the cystic wall of the lesions was thin after enhancement. The cyst wall and septum were slightly to moderately enhanced, the contents of the capsule were not enhanced except for the septum, and the pathological diagnosis was all spongiform lymphangioma. The other 4 cases were round in shape, homogeneous in density, and had no separated lesions. The cystic wall of the lesions was thin after enhancement. The cyst wall was enhanced slightly to moderately, the density of the contents of the capsule was uniform, and no enhancement was found in all the cases. One case was misdiagnosed as splenic cyst in all the 10 cases of cystic lymphangioma diagnosed by pathology. Conclusion solitary lymphangioma of spleen is rare, and the incidence of solitary lymphangioma in adults is significantly higher than that in children. There are no obvious symptoms or mild symptoms in the patients. The course of disease is longer and the progression is slow. The CT features of solitary lymphangioma are related to the pathological types. The CT plain scan lesions of spongiform lymphangioma were irregular in shape, lobulated, uneven in density, uneven in thickness, enhanced in the posterior cystic wall and mildly to moderately enhanced, and the contents of the capsule were not enhanced except for the septum. The CT plain scan lesions of cystic lymphangioma were regular in shape, round in shape, uniform in density and without internal separation. After enhancement, the cystic wall was thinner, the cyst wall was mildly to moderately enhanced, and the contents of the cyst were not enhanced and the density was uniform.
【作者單位】： 湖北醫(yī)藥學(xué)院附屬太和醫(yī)院放射影像中心;
【分類號(hào)】：R733.2;R730.44

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