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目的:探讨红髓型脾脏错构瘤(SH)的MSCT特点。方法:回顾性分析经手术病理证实的13例红髓型SH的临床及CT影像资料,所有病例均行64层螺旋CT平扫及增强扫描。结果:13例均为单发,共13个病灶,直径4.6~10.5 cm。CT平扫病灶呈等密度者9例,境界不清,呈稍低密度者4例,境界清楚,病灶内均无脂肪成分及钙化,坏死和囊变少见。增强后平扫呈等密度的9例病灶呈不均匀性斑片状轻度强化,平扫呈稍低密度的4例病灶呈不均匀性斑块状明显强化,随时间延迟所有病灶均呈渐进性均匀强化。延迟期病灶密度接近或等于周围正常脾实质的密度,其中误诊为脾脏血管瘤、恶性肿瘤各1例。结论:脾脏错构瘤不同于其他器官的错构瘤,有其自身特点:病灶内常无脂肪成分及钙化灶,当发现脾内单发等密度或稍低密度肿块,增强后病灶呈弥漫性不规则,不均匀性斑片状或斑块状强化,且随时间延迟呈渐进性均匀强化等特征时,应首先考虑脾脏错构瘤,且多为红髓型。
Objective: To investigate the MSCT characteristics of red pulp spleen hamartoma (SH). Methods: The clinical and CT imaging data of 13 cases of red pulp type SH confirmed by surgery and pathology were retrospectively analyzed. All patients underwent 64-slice spiral CT scan and enhanced scan. Results: All the 13 cases were solitary and had 13 lesions with a diameter of 4.6-10.5 cm. CT plain lesions in 9 cases were equal density, unclear, slightly lower density in 4 cases, the realm of clear, no fatty components and calcification, necrosis and cystic degeneration rare. After enhancement, the density of 9 cases showed equal density of lesions were non-uniform patchy mild enhancement, plain showed a slightly lower density of 4 lesions were inhomogeneous plaque was significantly enhanced, with the delay of all lesions were progressive Uniform sexual enhancement. Delayed lesion density close to or equal to the surrounding normal density of spleen parenchyma, of which misdiagnosed as splenic hemangiomas, malignant tumors in 1 case. Conclusion: Spleen hamartoma is different from hamartoma of other organs. It has its own characteristics: often fat-free components and calcification in the lesion. When single splenomegaly or low density mass is found in the spleen, the lesions are diffuse Irregular, uneven patchy or plaque-like enhancement, and with the gradual progressive enhancement of the time delay and other characteristics, we should first consider the spleen hamartoma, and mostly red-type.