脾脏影像诊断学培训讲学.pptVIP

脾脏影像诊断学 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 10 20 60 30 Arciform normal enhancement pattern Axial 3D GRE VIBE Immediately after administration of contrast material Arciform normal enhancement pattern 脾的异常CT表现 平扫 脾增大 数目：多、副、无 密度异常 低密度：肿瘤、脓肿、囊肿、梗死、挫伤 高密度：外伤血肿、错构瘤、钙化 对比增强 病灶强化：血管瘤、淋巴瘤、转移瘤 环状强化：脓肿 病灶无强化：囊肿、梗死 MRI影像分析 横断面大小、形态与CT相似 冠状面显示脾的大小、形态及其与邻近器官的关系优于横断面 T1WI信号低于肝 T2WI信号高于肝 血管流空无信号 副脾、多脾及异位脾，信号强度始终与脾相同 脾肿瘤呈稍长T1长T2信号 如肿瘤伴出血坏死，则为混杂信号 囊性病变呈圆形长T1低信号和长T2高信号 脾内出血的信号与出血时间有关 脾内钙化呈黑色低信号 Normal Variants: Accessory Spleen 10% Solitary or multiple and no more than 4cm common