脾脏硬化性血管瘤样结节性转化的临床特征及影像表现  

Clinical characteristics and imaging manifestations of splenic sclerosing angiomatoid nodular transformation

作　　者：张佳琪 王慧[3] 李海宁[1] 张莉[2] 张明[1] ZHANG Jiaqi;WANG Hui;LI Haining;ZHANG Li;ZHANG Ming(Department of Radiology,the First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China;Department of MRI,the Second People's Hospital of Lanzhou,Gansu Lanzhou 730046,China;School of Future Technology,Xi'an Jiaotong University,Shaanxi Xi'an 710049,China.)

机构地区：[1]西安交通大学第一附属医院影像科,陕西西安710061 [2]兰州市第二人民医院核磁科,甘肃兰州730046 [3]西安交通大学未来技术学院,陕西西安710049

出　　处：《现代肿瘤医学》2024年第14期2615-2619,共5页Journal of Modern Oncology

基　　金：国家自然科学基金(编号:81371530)。

摘　　要：目的:探讨脾脏硬化性血管瘤样结节性转化(sclerosing angiomatoid nodular transformation, SANT)的临床症状、病理及影像学特征,提高对脾脏SANT术前诊断的准确性。方法:回顾性收集6例经手术或穿刺病理证实为脾脏SANT患者的临床及影像学资料,对病灶的大小、形态、边界、超声、CT、MRI信号及强化情况进行观察和分析。结果:6例脾脏SANT中4例患者表现为上腹部胀痛,2例患者因体检或其他疾病住院行腹部超声检查发现脾脏病变。病理学特征为纤维硬化间质中形成多个血管瘤样结节。病灶在超声上表现为等或稍低回声,部分可见高回声。CT平扫表现为等低密度。在MRI上,T1WI(T1-weighted imaging)病灶呈稍低信号,T2WI(T2-weighted imaging)呈高信号,病灶中央可见“星芒状”稍低信号;增强扫描动脉期表现为“轮辐征”,后期渐进性强化,增强扫描延迟期中心区域纤维组织延迟强化。结论:脾脏SANT常表现为上腹痛或无明显临床症状,MRI对脾脏SANT的显示优于CT及超声,T2WI及增强扫描动脉期特征性的“轮辐征”,可以很好的与其他疾病鉴别。Objective:To investigate the clinical symptoms,pathology and imaging features of sclerosing angiomatoid nodular transformation(SANT)of the spleen,and to improve the accuracy of preoperative diagnosis of SANT of the spleen.Methods:The clinical and imaging data of 6 patients with surgically or pathologically confirmed SANT of the spleen were retrospectively collected.The size,shape,boundary,ultrasound,CT and MRI signals and enhancement of the lesions were observed and analyzed.Results:Among the 6 cases of SANT of the spleen,4 patients presented with upper abdominal pain and tenderness,and 2 patients were found to have splenic lesions during abdominal ultrasound examination due to physical examination or hospitalization for other diseases.The pathological features were multiple angioma-like nodules formed in the fibrotic and sclerotic interstitial tissue.The lesions were hypoechoic or slightly hypoechoic on ultrasound,and some had high echoes.CT plain scan showed isodense or slightly hypodense lesions.On MRI,T1-weighted imaging(T1WI)showed slightly hypointense lesions,T2-weighted imaging(T2WI)showed hyperintense lesions,and a"stellate"slightly hypointense signal was visible in the central area of the lesion.Arterial phase enhancement scanning showed a"spoke-wheel"sign,and delayed enhancement of the central fibrotic tissue was observed in the delayed phase of enhancement scanning.Conclusion:SANT of the spleen often manifests as upper abdominal pain or no significant clinical symptoms.MRI is superior to CT and ultrasound in demonstrating SANT of the spleen.The characteristic"spoke-wheel"sign on T2WI and arterial phase enhancement scanning can be used to distinguish SANT of the spleen from other diseases.

关 键 词：硬化性血管瘤样结节性转化 脾脏 影像表现 鉴别诊断 

分 类 号：R733.2[医药卫生—肿瘤]