脾脏和胰腺内副脾表皮样囊肿的影像学表现  

Imaging features of epidermoid cyst in the spleen and the intrapancreatic accessory spleen

作　　者：赵丰平[1] 王玉涛[2] 邓茜 张建 朱玉兆 ZHAO Fengping;WANG Yutao;DENG Qian;ZHANG Jian;ZHU Yuzhao(PET/CT Center,Qinghai People's Hospital,Xining 810000,China;Department of Radiology,the Affiliated Hospital of Medical School of Ningbo University,Ningho 315020,China;Department of Histology and Pathology,Ningho Clinical and Pathological Diagnosis Center,Ningho 315021,China;Universal Medical Imaging Diagnostic Center,Shanghai 201103,China)

机构地区：[1]青海省人民医院PET/CT中心,青海西宁810000 [2]宁波大学医学院附属医院影像科,浙江宁波315020 [3]宁波市临床病理诊断中心组织病理科,浙江宁波315021 [4]上海全景医学影像诊断中心,上海201103

出　　处：《实用放射学杂志》2019年第9期1448-1452,共5页Journal of Practical Radiology

摘　　要：目的探讨脾脏和胰腺内副脾表皮样囊肿的CT、MRI及18F-FDG PET/CT表现。方法回顾性分析11例经手术病理证实的脾脏和胰腺内副脾表皮样囊肿的影像学资料,包括增强CT 10例,增强MRI 3例,PET/CT 1例,观察分析脾表皮样囊肿的影像学特征。结果(1)6例表皮样囊肿位于脾脏,5例位于胰腺内副脾。脾脏、胰腺内副脾表皮样囊肿直径分别为(11.1±4.4)cm和(3.8±0.2)cm,向日葵花瓣样表现分别为3例和2例。(2)CT表现:脾脏表皮样囊肿6例,多房性、单房性均为3例,囊腔多为低密度,囊壁钙化1例;1例较厚囊壁呈轻至中度强化。胰腺内副脾表皮样囊肿4例,多房性2例,囊腔呈低或等密度,囊壁钙化1例;囊壁、分隔轻度强化。(3)MRI表现:脾脏表皮样囊肿2例,均为多房性,囊腔多为T1WI高、T2WI稍高或高信号,囊壁为T1WI稍低、T2WI低信号;增强扫描囊壁及分隔不强化或轻度强化;DWI上囊腔呈高信号,囊壁呈低信号,且较T2WI“增宽”。(4)PET/CT表现:脾脏表皮样囊肿1例,囊壁呈不连续厚环样18F-FDG摄取增高,囊腔呈放射性摄取缺失。结论脾脏和胰腺内副脾表皮样囊肿的向日葵花瓣表现有一定特征,前者体积较大,囊壁T2WI、DWI呈低信号,囊腔DWI呈高信号,后者为胰尾部的囊肿伴类似脾脏密度/信号“假囊壁”,最终明确还需结合病理。Objective To investigate the CT, MRI and 18F-FDG PET/CT features of epidermoid cyst in the spleen and the intrapancreatic accessory spleen. Methods Imaging data of 11 cases with epidermoid cyst in the spleen and the intrapancreatic accessory spleen confirmed by pathology was analyzed retrospectively. 10 cases underwent enhanced CT, 3 cases underwent enhanced MRI, and 1 case underwent PET/CT. Imaging characteristics of the epidermoid cyst were analyzed.Results (1) Within 11 cases, 6 cases were in the spleen and 5 cases were in the intrapancreatic accessory spleen.The diameters of the lesions were (11.1±4.4) cm and (3.8±0.2) cm,respectively.Sunflower appearance was found in 3 and 2 cases, respectively.(2) CT findings:Of the spleen epidermoid cysts (n = 6), there were 3 cases with multilocular cysts and 3 cases with monolocular cyst;The cystic cavities were low density, and calcification in the cystic wall was seen in 1 case;Mild to moderate enhancement of the thick cystic wall was seen in 1 case. Of the intrapancreatic accessory spleen lesions (n=4), there were 2 cases with multilocular cysts;The cystic cavities showed hyperintensity or isointensity, and calcification in the cystic wall was seen in 1 case;Slightly enhancement was seen in the cyst wall and septa.(3) MRI findings: High signal on T1WI and slightly high or high signal on T2 WI were seen in 2 multilocular spleen epidermoid cysts. The cystic wall showed slightly low signal on Ti WI and low signal on T2 WI. The cyst wall and septa showed mild or non-enhancement. On DWI, the cystic cavity showed high signal;The cystic wall was low signal, and wider than that on T2WI.(4)On PET/CT findings:The cystic wall showed a discontinuously thicker rim with high 18F-FDG uptake,and the cystic cavity was no 18 F-FDG uptake.Conclusion Sunflower appearance may be a characteristic manifestation of epidermoid cyst. The volume of the splenic lesion is larger.The cyst wall is hypointensity on both T2 WI and DWI,and the cystic cavity is hyperintensity on DWI. The lesion in th

关 键 词：脾脏 胰腺内副脾 表皮样囊肿 计算机体层成像 磁共振成像 正电子发射断层显像 

分 类 号：R551.1[医药卫生—血液循环系统疾病] R576[医药卫生—内科学]