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目的探讨脾肿瘤CT表现和鉴别诊断价值。方法52例脾肿瘤均行CT平扫+增强检查,其中手术及穿刺活检病理证实27例,征象典型及病史明确25例。结果脾良性肿瘤18例,恶性肿瘤34例。良性肿瘤表现为脾脏内单发或多发,多数大小不等低密度结节病变,1例血管瘤为等密度。血管瘤及淋巴管瘤可显示点状或小片状钙化。增强扫描,血管瘤显示延迟均匀强化特点,淋巴管瘤内间隔可轻度强化。脾囊肿无强化。脾脏恶性肿瘤多较大,密度不均匀,增强扫描不均匀强化。脾淋巴瘤表现为脾肿大或多发结节样低密度病变,增强扫描强化不明显。结论CT是诊断脾肿瘤的主要检查方法,结合临床及B超检查,多可做出诊断。
Objective To investigate the CT findings and differential diagnosis of splenic tumors. Methods Fifty-two patients with splenic tumors underwent CT scan and contrast enhancement. Twenty-seven cases were confirmed by operation and biopsy, with 25 typical signs and definite history. Results Spleen benign tumors in 18 cases, 34 cases of malignant tumors. Benign tumors showed splenic solitary or multiple, most ranging in size from low density nodular lesions, one case of hemangiomas for the same density. Hemangiomas and lymphangiomas can show punctate or small pieces of calcification. Enhanced scanning, hemangiomas showed uniform delay enhancement characteristics, lymphangioma within the interval can be slightly enhanced. No enhancement of the spleen cyst. Malignant splenomegaly larger, uneven density, enhanced scan unevenly enhanced. Splenic lymphoma showed splenomegaly or multiple nodular low-density lesions, enhanced scan enhancement is not obvious. Conclusion CT is the main method for the diagnosis of splenic tumors. Combined with clinical and B-ultrasound, more diagnosis can be made.