脾脏影像学资料.ppt

脾脏影像诊断学 放射学院 刘林祥 脾脏影像检查技术 X线：价值有限，血管造影 US CT：为更清楚显示小病变，可应用5mm的层厚和层距 平扫发现可疑应增强 MR Imaging Technique Coronal T2WI half-Fourier rapid acquisition with relaxation enhancement (RARE) Axial FSE T2WI or long echo time inversion-recovery imaging performed during a breath hold Axial GRE T1WI chemical shift in-phase and out-of-phase imaging performed during a breath hold Axial 3D GRE breath-hold sequence such as volumetric interpolated breath-hold examination (VIBE) with pre-contrast and dynamic enhanced MR Imaging Technique Lower than liver on T1WI and higher on T2WI Images obtained immediately after enhancement usually demonstrate different circulations as regions of alternating high and low signal intensity, resulting in a serpentine or arciform pattern Becomes homogeneous approximately 60–90s after contrast material administration Anatomy The largest ductless gland and the largest single lymphatic organ in the body mesodermal in origin to the circulatory system as the lymph nodes functions include immunologic surveillance, red blood cell breakdown, and splenic contraction for blood volume augmentation during hemorrhage A wide range of pathology can affect the spleen Anatomy An intraperitoneal organ with a smooth serosal surface and attached to the retroperitoneum by fatty ligaments surfaces: diaphragmatic (phrenic) and visceral Visceral surface is divided into an anterior or gastric ridge and a posterior or renal portion Splenic artery and vein emerge from the splenic hilum in the form of six or more branches; the splenic artery is remarkable for its large size and tortuosity. slightly superior to the vein Microscopic Anatomy divided into two compartments, the red and white pulps, separated by the marginal zone The white pulp is made up of T and B lymphocytes and located centrally The red pulp is composed of rich plexuses of tortuous venous sinuses 脾的大小 新月形或内缘凹陷的半月形，密度均匀略低于肝 前后径7～10㎝ 宽径4～6㎝ 上下径11～15㎝ 动脉期强化不均匀静脉期和实质期密度逐渐均匀一致 Arciform normal enhancement patte