CT在脾脏占位性病变诊断及鉴别诊断中的价值.pdfVIP

放射学实践2008年 1月第23卷第1期 Radiol Practice，Jan 2008，Vol 23，No．1 5l · 腹部影像学 · CT在脾脏占位性病变诊断及鉴别诊断中的价值 周莹，周胜利，刘雨成，张永刚 【摘要】 目的：探讨CT在脾脏占位性病变鉴别诊断中的价值。方法：回顾性分析25例经手术病理证实的脾脏占位 性病变的CT及病理学资料，分析脾脏占位性病变的CT特征。结果：良性占位性病变中9O．9 脾脏为正常至轻度肿大， 而恶性 57．1 为重度脾脏肿大。良性占位性病变多为单发病灶，边界清晰，钙化多见，呈蛋壳样钙化，淋巴结少见肿大；恶 性病变常为多发病灶，边界欠清，钙化少见，呈砂粒样或结节样，淋巴结肿大及腹水多见。结论：脾脏占位性病变CT袁现 具有一定的特征性，结合临床病史多可正确诊断。 【关键词】 脾疾病；体层摄影术，x线计算机；诊断，鉴别 【中图分类号】R551．1；R814．42 【文献标识码】A 【文章编号】1000—0313(2008)01—0051-03 Value of CT in the Differential Diagnosis of Splenic Neoplasms ZHOU Ying，ZHOU Sheng—li，LIU Yu—chen，et a1．Depart— ment of Radiology，the First Hospital of Lianyungang，Jiangsu 222002，P．R．China [Abstract] Objective：To assess the value of computed tomography(CT)in the differential diagnosis of splenic neo— plasms．Methods：The CT findings of 25 cases with surgery and pathology proved splenic neoplasms(11 benign and 14 ma— lignant)were retrospectively studied．The CT characteristics and the pathologic findings were correlated．Results：Among the benign lesions，no splenomegaly was assessed in 10 cases(90．9 )，yet 8 cases(57．1 )with malignancy showed sple— nomegaly．Well—defined solitary lesion，intra tumoral eggshell—like calcifications，with no lymphadenopathy were showed in benign masses．However，multiple ill—defined lesions，intra—tumoral granular or nodular calcification and enlargement of lymph nodes were found in malignant lesions．ConclI／sion：There were certain CT findings which were helpful in the diagno— sis of space occupying splenic lesions．Accurate diagnosis could be obtained mostly，when the CT findings were correlated with clinical history． [Key words] Splenic diseases；Tomography，X—ray computed；Diagnosis，differential 脾脏是重要的外周免疫器官，其占位性病变的发 访时间为3个月--2年，1例血管肉瘤为穿刺活检病理 生率较低且临床表现大多缺乏特异性，良性占位性病 证实，其余2