脾脏肿瘤与非肿瘤性病变的CT鉴别
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摘要
目的:探讨脾脏肿瘤与非肿瘤性病变的CT表现及鉴别应用。方法:回顾性分析69例经临床确诊为脾脏病变的CT影像学资料,总结肿瘤性与非肿瘤性病灶影像特征及伴随征象,并采用卡方检验分析相关数据。结果:69例脾脏病变中,肿瘤性病变44例,边界不清者31.8%,出现包膜下积液者4.5%,出现腹膜增厚者2.3%;非肿瘤性病变25例,边界不清者56.0%,出现包膜下积液者60.0%,出现腹膜增厚者24.0%,脾脏肿瘤与非肿瘤性病变在三者的影像表现均有统计学差异(P<0.05)。结论:CT可较清晰地显示脾脏病灶,通过对病灶的边界及伴随征象的分析,有利于对脾脏肿瘤与非肿瘤性病变的鉴别。
Objective:To explore the manifestations of tumorous and non-tumorous lesions in the spleen on computed tomography(CT)and the application of CT in their differentiation. Methods:A retrospective analysis was carried out on the CT data of 69 patients diagnosed with splenic lesions;the imaging characteristics of tumorous and non-tumorous lesions and their accompanying signs were summarized;the chi-square test was used to analyze related data. Results:Among the 69 patients with splenic lesions,44 had tumor ous lesions,and 25 had non-tumorous lesions,with the percentages of patients with unclear boundary,subcapsular effusion,and peritoneal thickening to be 31.8%,4.5%,and 2.3%,respectively,in the former population,versus 56.0%,60.0%,and 24.0%,respectively,in the latter population;there were significant differences in the imaging findings of all three pathological changes between the patients with tumorous lesions and non-tumorous lesions(P<0.05). Conclusion:Splenic lesions can be clearly shown on CT. By analyzing the boundaries of lesions and accompanying signs,it is beneficial to differentiate tumorous lesions from non-tumorous lesions in the spleen.
Objective:To explore the manifestations of tumorous and non-tumorous lesions in the spleen on computed tomography(CT)and the application of CT in their differentiation. Methods:A retrospective analysis was carried out on the CT data of 69 patients diagnosed with splenic lesions;the imaging characteristics of tumorous and non-tumorous lesions and their accompanying signs were summarized;the chi-square test was used to analyze related data. Results:Among the 69 patients with splenic lesions,44 had tumor ous lesions,and 25 had non-tumorous lesions,with the percentages of patients with unclear boundary,subcapsular effusion,and peritoneal thickening to be 31.8%,4.5%,and 2.3%,respectively,in the former population,versus 56.0%,60.0%,and 24.0%,respectively,in the latter population;there were significant differences in the imaging findings of all three pathological changes between the patients with tumorous lesions and non-tumorous lesions(P<0.05). Conclusion:Splenic lesions can be clearly shown on CT. By analyzing the boundaries of lesions and accompanying signs,it is beneficial to differentiate tumorous lesions from non-tumorous lesions in the spleen.
引文
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[2]Lee WS,Choi ST,Kim KK.Splenic abscess:a single institution study and review of the literature[J].Yonsei Med J,2011,52(2):288-292.
[3]Zhang Y,Zhang J,Chen T,et al.Spontaneous splenic rupture in an acute leukemia patient with splenic tuberculosis:a case report[J].Mol Clin Oncol,2017,6(2):209-213.
[4]刘海龙,刘敏,刘艳,等.脾脏窦岸细胞血管瘤的影像表现[J].中华放射学杂志,2013,47(5):440-443.
[5]Peckova K,Michal M,Hadravsky L,et al.Littoral cell angioma of the spleen:a study of 25 cases with confirmation of frequent association with visceral malignancies[J].Histopathology,2016,69(5):762-774.
[6]Sinha MK,Raghuwanshi B,Bag ND,et al.Splenic infarction in two members of the family with sickle cell trait:a case report of rare complication[J].Int J Appl Basic Med Res,2017,7(4):272-274.
[7]彭通略,徐铭,文明.结核性与肿瘤性腹腔积液的CT鉴别(附43例分析)[J].医学影像学杂志,2014,25(6):987-990.
[8]陈海雄,胡秋根,王秋实,等.弥漫型恶性腹膜间皮瘤的MDCT征象分析及其鉴别诊断[J].临床放射学杂志,2015,34(1):83-87.
[9]Chang HK,Han SJ,Choi SH,et al.Feasibility of a laparoscopic approach for generalized peritonitis from perforated appendicitis in children[J].Yonsei Med J,2013,54(6):1478-1483.
[10]Sharma V,Bhatia A,Malik S,et al.Visceral scalloping on abdominal computed tomography due to abdominal tuberculosis[J].Ther Adv Infect Dis,2017,4(1):3-9.