脾臟病變CT/MRI診斷進展_West China Medical Journal

Authors：

張菁 ,  伍兵 , 莊宇 , 楊嵐清

四川大學華西醫院放射科（成都 610041）;

Corresponding?author：

伍兵, Email: bingwu69@163.com

Keywords：

脾臟; 影像; 體層攝影術，X線計算機; 磁共振成像; 進展

DOI：

10.7507/1002-0179.201702205

Video：

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Abstract Full text Figures/Tables Video References Cited by

隨著影像技術的發展，脾臟的變異與病變越來越受到臨床醫生以及放射科醫生關注。因此，該文通過CT和MRI 對脾臟的先天變異、脾臟良性占位病變、惡性病變、門脈系統高壓等病變的診斷進展進行簡要概述，以指導臨床及放射科醫生對脾臟病變進行早期、準確的診斷。

Citation： 張菁, 伍兵, 莊宇, 楊嵐清. 脾臟病變CT/MRI診斷進展. West China Medical Journal, 2017, 32(10): 1606-1610. doi: 10.7507/1002-0179.201702205 Copy

1.	Liu HT, Lau KK. Wandering spleen: an unusual association with gastric volvulus. AJR Am J Roentgenol, 2007, 188(4): W328-W330.
2.	Flores-Ríos E, Méndez-Díaz C, Rodríguez-García E, et al. Wandering spleen, gastric and pancreatic volvulus and right-sided descending and sigmoid colon. J Radiol Case Rep, 2015, 9(10): 18-25.
3.	Priyadarshi RN, Anand U, Kumar B, et al. Torsion in wandering spleen: CT demonstration of whirl sign. Abdom Imaging, 2013, 38(4): 835-838.
4.	Lombardi R, Menchini L, Corneli TA, et al. Wandering spleen in children: a report of 3 cases and a brief literature review underlining the importance of diagnostic imaging. Pediatr Radiol, 2014, 44(3): 279-288.
5.	彭俊紅, 劉松, 周利華, 等. 特殊副脾的 CT 與 MRI 征象. 世界華人消化雜志, 2013, 21(10): 925-930.
6.	程偉中, 曾蒙蘇, 饒圣祥, 等. 胰腺異位副脾的影像學診斷(附 3 例報告并文獻復習). 放射學實踐, 2007, 22(11): 1196-1198.
7.	Kim SH, Lee JM, Han JK, et al. Intrapancreatic accessory spleen: Findings on Mr imaging, CT, US and scintigraphy, and the pathologic analysis. Korean J Radiol. 2008, 9(2): 162-174.
8.	于春海, 李婷, 李健丁. 胰腺內副脾的影像學研究現狀及進展. 國際醫學放射學雜志, 2013, 36(2): 127-130.
9.	Mortelé1 KJ, Mortelé B, Silverman SG. CT features of the accessory spleen. AJR, 2004, 183(6): 1653-1657.
10.	趙大聰, 余暉, 李鑫, 等. 副脾典型及不典型MRI表現分析. 醫學影像學雜志, 2015(7): 1301-1303.
11.	Jang KM, Kim SH, Lee SJ, et al. Differentiation of an intrapancreatic accessory spleen from a small (<3-cm) solid pancreatic tumor: value of diffusion-weighted Mr imaging. Radiology, 2013, 266(1): 159-167.
12.	Massani M, Maccatrozzo P, Morana G, et al. Diagnostic difficulties and therapeutic choices in intrapancreatic accessory spleen: case reports. 2016, 9: 15-20.
13.	Rashid SA. Accessory spleen: prevalence and multidetector CT appearance. Malays J Med Sci, 2014, 21(4): 18-23.
14.	Yoneyama H, Kondo C, Yamasaki A, et al. Comparison of situs ambiguous patterns between heterotaxy syndromes with polysplenia and asplenia. Eur J Radiol, 2015, 84(11): 2301-2306.
15.	Apisarnthanarak P, Thairatananon A, Muangsomboon K, et al. Computed tomography characteristics of hepatic and splenic abscesses associated with melioidosis: a 7-year study. J Med Imaging Radiat Oncol, 2011, 55(2): 176-182.
16.	Laopaiboon V, Chamadol N, Buttham H, et al. CT findings of liver and splenic abscesses in melioidosis: comparison with those in non-melioidosis. J Med Assoc Thai, 2009, 92(11): 1476-1484.
17.	Ozogul B, Kisaoglu A, Atamanalp SS, et al. Splenic hydatid cysts: 17 cases. Indian J Surg, 2015, 77(Suppl 2): 257-260.
18.	Gaetke-Udager K, Wasnik AP, Kaza RK, et al. Multimodality imaging of splenic lesions and the role of non-vascular, image-guided intervention. Abdom Imaging, 2014, 39(3): 570-587.
19.	林斐顓, 屠金夫, 楊繼安, 等. 脾血管瘤 18 例診斷及外科治療. 肝膽胰外科雜志, 2013, 25(1): 23-26.
20.	Falk S, Stutte HJ, Frizzera G. littoral cell angioma. A novel splenic vascular lesion demonstrating histiocytic differentiation. Am J Surg Pathol, 1991, 15(11): 1023-1033.
21.	許曉泉, 劉希勝, 徐青, 等. 脾臟竇岸細胞血管瘤的 CT 診斷及文獻回顧. 實用放射學雜志, 2012, 28(11): 1803-1806.
22.	Martel M, Cheuk W, Lombardi L, et al. Sclerosing angiomatoid nodular transformation (SANT): report of 25 cases of a distinctive benign splenic lesion. Am J Surg Pathol. 2004. 28(10): 1268-1279.
23.	譚延斌, 方圣偉, 胡婷婷, 等. 脾臟硬化性血管瘤樣結節性轉化的影像表現及其病理基礎. 實用放射學雜志, 2013, 29(10): 1613-1616.
24.	Karaosmanoglu DA, Karcaaltincaba M, Akata D. CT and MRI findings of sclerosing angiomatoid nodular transformation of the spleen: spoke wheel pattern. Korean J Radiol, 2008, S52-S55.
25.	Saboo SS, Krajewski KM, O’Regan KN, et al. Spleen in haematological malignancies: spectrum of imaging findings. Br J Radiol, 2012, 85(1009): 81-92.
26.	Sutherland T, Temple F, Hennessy O. Abdomen’s forgotten organ: Sonography and CT of focal splenic lesions. J Med Imaging Radiat Oncol, 2010, 54(2): 120-128.
27.	陸永文, 謝婷婷, 王成林. 中國 CT 和 MRI 雜志, 2015, 13(4): 79-80, 轉104.
28.	Luna A1, Ribes R, Caro P, et al. MRI of Focal Splenic Lesions Without and With Dynamic Gadolinium Enhancement. AJR Am J Roentgenol, 2006, 186(6), 1533-1547.
29.	Weissleder R, Elizondo G, Stark DD, et al. The diagnosis of splenic lymphoma by Mr imaging: value of superparamagnetic Iron oxide. AJR Am J Roentgenol, 1989, 152(1): 175-180.
30.	Abdullah A, Michael P, Mariano S, et al. Cross-Sectional Imaging of Nontraumatic Emergencies of the Spleen. Curr Probl in Diagn Radiol, 2014. 43(5): 254-267.
31.	Kaushik C, Relia N, Jambhekar K, et al. Unusual CT and Mr imaging characteristics of splenic lymphoma. Case Rep Oncol Med, 2011(期缺失): 298357.
32.	詹勇, 向子云, 王靜波, 等. 脾淋巴瘤的 CT 影像學特征. 中國醫學影像學雜志, 2011, 19(2): 139-142.
33.	陽紅艷, 許乙凱. 脾臟占位性病變的影像學診斷現狀. 中國臨床醫學影像雜志, 2005, 16(5): 282-285.
34.	Jang KM, Kim SH, Hwang J, et al. Differentiation of malignant from benign focal splenic lesions: added value of Diffusion-Weighted MRI. AJR Am J Roentgenol, 2014, 203(4): 803-812.
35.	Lee WK, Lau EW, Duddalwar VA, et al. Abdominal Manifestations of Extranodal Lymphoma: Spectrum of Imaging Findings. AJR Am J Roentgenol, 2008. 191(1): 198-206.
36.	Thipphavong S, Duigenan S, Schindera ST, et al. Nonneoplastic, Benign, and Malignant Splenic Diseases: Cross-Sectional Imaging Findings and Rare Disease Entities. AJR Am J Roentgenol, 2014, 203(2): 315-322.
37.	Comperat E, Bardier-Dupas A, Camparo P, et al. Splenic metastases: clinicopathologic presentation, differential diagnosis, and pathogenesis. Arch Pathol Lab Med, 2007, 131(6): 965-969.
38.	Piura B, Rabinovich A, Apel-Sarid LA. Splenic metastasis from endometrial carcinoma: report of a case and review of literature. Arch Gynecol Obstet, 2009, 280(6): 1001-1006.
39.	Yang HY, Xu YK, Wu YK, et al. Superparamagnetic iron oxide: enhanced detection of splenic VX2 tumor with magnetic resonance imaging in rats. 中國組織工程研究與臨床康復, 2007, 11(44): 9001-9005.
40.	Thompson WM, Levy AD, Aguilera NS, et al. Angiosarcoma of the spleen: Imaging characteristics in 12 patients. Radiology, 2005, 235(1): 106-115.
41.	Qi R, Yu JQ, Xu H, et al. Primary angiosarcoma of the spleen as depicted on computed tomography. Clin Imaging, 2012, 36(5): 619-622.
42.	Duan YF, Jiang Y, Wu CX, et al. Spontaneous rupture of primary splenic angiosarcoma: a case report and literature review.. World J Surg Oncol, 2013, 11: 53.
43.	Lee J, Kim KW, Lee H, et al. Semiautomated spleen volumetry with diffusion-weighted MR imaging. Magn Reson Med, 2012, 68(1): 305-310.
44.	Razek AA, Massoud SM, El-Bendary MM, et al. Prediction of esophageal varices in cirrhotic patients with apparent diffusion coefficient of the spleen. Abdom Imaging, 2015, 40(6): 1465-1469.
45.	Shin SU, Lee JM, Yu MH, et al. Prediction of esophageal varices in patients with cirrhosis: usefulness of three-dimensional Mr elastography with echo-planar imaging technique. Radiology, 2014, 272(1): 143-153.
46.	Ronot M, Lambert S, Elkrief L, et al. Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency Mr elastography in liver cirrhosis. Eur Radiol, 2014, 24(6): 1394-1402.
47.	Hu X, Xu X, Zhang Q, et al. Indirect prediction of liver fibrosis by quantitative measurement of spleen stiffness using the FibroScan system. J Ultrasound Med, 2014, 33(1): 73-81.
48.	陶曉娟, 彭蕓, 呂艷秋, 等. 磁共振定量測定兒童及青少年戈謝病肝脾臟體積及脂質含量. 中國醫學影像技術, 2016, 32(7): 1080-1083.
49.	Papakonstantinou O, Drakonaki EE, Maris TA, et al. Mr imaging of spleen in beta-thalassemia major. Abdom Imaging, 2015, 40(7): 2777-2782.
50.	Casey J, Brewer BS, Thomas D, et al. Spleen R2 and R2*in Iron-Overloaded patients with sickle cell disease and thalassemia major. J Magn Reson Imaging, 2009, 29(2): 357-364.

1. Liu HT, Lau KK. Wandering spleen: an unusual association with gastric volvulus. AJR Am J Roentgenol, 2007, 188(4): W328-W330.
2. Flores-Ríos E, Méndez-Díaz C, Rodríguez-García E, et al. Wandering spleen, gastric and pancreatic volvulus and right-sided descending and sigmoid colon. J Radiol Case Rep, 2015, 9(10): 18-25.
3. Priyadarshi RN, Anand U, Kumar B, et al. Torsion in wandering spleen: CT demonstration of whirl sign. Abdom Imaging, 2013, 38(4): 835-838.
4. Lombardi R, Menchini L, Corneli TA, et al. Wandering spleen in children: a report of 3 cases and a brief literature review underlining the importance of diagnostic imaging. Pediatr Radiol, 2014, 44(3): 279-288.
5. 彭俊紅, 劉松, 周利華, 等. 特殊副脾的 CT 與 MRI 征象. 世界華人消化雜志, 2013, 21(10): 925-930.
6. 程偉中, 曾蒙蘇, 饒圣祥, 等. 胰腺異位副脾的影像學診斷(附 3 例報告并文獻復習). 放射學實踐, 2007, 22(11): 1196-1198.
7. Kim SH, Lee JM, Han JK, et al. Intrapancreatic accessory spleen: Findings on Mr imaging, CT, US and scintigraphy, and the pathologic analysis. Korean J Radiol. 2008, 9(2): 162-174.
8. 于春海, 李婷, 李健丁. 胰腺內副脾的影像學研究現狀及進展. 國際醫學放射學雜志, 2013, 36(2): 127-130.
9. Mortelé1 KJ, Mortelé B, Silverman SG. CT features of the accessory spleen. AJR, 2004, 183(6): 1653-1657.
10. 趙大聰, 余暉, 李鑫, 等. 副脾典型及不典型MRI表現分析. 醫學影像學雜志, 2015(7): 1301-1303.
11. Jang KM, Kim SH, Lee SJ, et al. Differentiation of an intrapancreatic accessory spleen from a small (<3-cm) solid pancreatic tumor: value of diffusion-weighted Mr imaging. Radiology, 2013, 266(1): 159-167.
12. Massani M, Maccatrozzo P, Morana G, et al. Diagnostic difficulties and therapeutic choices in intrapancreatic accessory spleen: case reports. 2016, 9: 15-20.
13. Rashid SA. Accessory spleen: prevalence and multidetector CT appearance. Malays J Med Sci, 2014, 21(4): 18-23.
14. Yoneyama H, Kondo C, Yamasaki A, et al. Comparison of situs ambiguous patterns between heterotaxy syndromes with polysplenia and asplenia. Eur J Radiol, 2015, 84(11): 2301-2306.
15. Apisarnthanarak P, Thairatananon A, Muangsomboon K, et al. Computed tomography characteristics of hepatic and splenic abscesses associated with melioidosis: a 7-year study. J Med Imaging Radiat Oncol, 2011, 55(2): 176-182.
16. Laopaiboon V, Chamadol N, Buttham H, et al. CT findings of liver and splenic abscesses in melioidosis: comparison with those in non-melioidosis. J Med Assoc Thai, 2009, 92(11): 1476-1484.
17. Ozogul B, Kisaoglu A, Atamanalp SS, et al. Splenic hydatid cysts: 17 cases. Indian J Surg, 2015, 77(Suppl 2): 257-260.
18. Gaetke-Udager K, Wasnik AP, Kaza RK, et al. Multimodality imaging of splenic lesions and the role of non-vascular, image-guided intervention. Abdom Imaging, 2014, 39(3): 570-587.
19. 林斐顓, 屠金夫, 楊繼安, 等. 脾血管瘤 18 例診斷及外科治療. 肝膽胰外科雜志, 2013, 25(1): 23-26.
20. Falk S, Stutte HJ, Frizzera G. littoral cell angioma. A novel splenic vascular lesion demonstrating histiocytic differentiation. Am J Surg Pathol, 1991, 15(11): 1023-1033.
21. 許曉泉, 劉希勝, 徐青, 等. 脾臟竇岸細胞血管瘤的 CT 診斷及文獻回顧. 實用放射學雜志, 2012, 28(11): 1803-1806.
22. Martel M, Cheuk W, Lombardi L, et al. Sclerosing angiomatoid nodular transformation (SANT): report of 25 cases of a distinctive benign splenic lesion. Am J Surg Pathol. 2004. 28(10): 1268-1279.
23. 譚延斌, 方圣偉, 胡婷婷, 等. 脾臟硬化性血管瘤樣結節性轉化的影像表現及其病理基礎. 實用放射學雜志, 2013, 29(10): 1613-1616.
24. Karaosmanoglu DA, Karcaaltincaba M, Akata D. CT and MRI findings of sclerosing angiomatoid nodular transformation of the spleen: spoke wheel pattern. Korean J Radiol, 2008, S52-S55.
25. Saboo SS, Krajewski KM, O’Regan KN, et al. Spleen in haematological malignancies: spectrum of imaging findings. Br J Radiol, 2012, 85(1009): 81-92.
26. Sutherland T, Temple F, Hennessy O. Abdomen’s forgotten organ: Sonography and CT of focal splenic lesions. J Med Imaging Radiat Oncol, 2010, 54(2): 120-128.
27. 陸永文, 謝婷婷, 王成林. 中國 CT 和 MRI 雜志, 2015, 13(4): 79-80, 轉104.
28. Luna A1, Ribes R, Caro P, et al. MRI of Focal Splenic Lesions Without and With Dynamic Gadolinium Enhancement. AJR Am J Roentgenol, 2006, 186(6), 1533-1547.
29. Weissleder R, Elizondo G, Stark DD, et al. The diagnosis of splenic lymphoma by Mr imaging: value of superparamagnetic Iron oxide. AJR Am J Roentgenol, 1989, 152(1): 175-180.
30. Abdullah A, Michael P, Mariano S, et al. Cross-Sectional Imaging of Nontraumatic Emergencies of the Spleen. Curr Probl in Diagn Radiol, 2014. 43(5): 254-267.
31. Kaushik C, Relia N, Jambhekar K, et al. Unusual CT and Mr imaging characteristics of splenic lymphoma. Case Rep Oncol Med, 2011(期缺失): 298357.
32. 詹勇, 向子云, 王靜波, 等. 脾淋巴瘤的 CT 影像學特征. 中國醫學影像學雜志, 2011, 19(2): 139-142.
33. 陽紅艷, 許乙凱. 脾臟占位性病變的影像學診斷現狀. 中國臨床醫學影像雜志, 2005, 16(5): 282-285.
34. Jang KM, Kim SH, Hwang J, et al. Differentiation of malignant from benign focal splenic lesions: added value of Diffusion-Weighted MRI. AJR Am J Roentgenol, 2014, 203(4): 803-812.
35. Lee WK, Lau EW, Duddalwar VA, et al. Abdominal Manifestations of Extranodal Lymphoma: Spectrum of Imaging Findings. AJR Am J Roentgenol, 2008. 191(1): 198-206.
36. Thipphavong S, Duigenan S, Schindera ST, et al. Nonneoplastic, Benign, and Malignant Splenic Diseases: Cross-Sectional Imaging Findings and Rare Disease Entities. AJR Am J Roentgenol, 2014, 203(2): 315-322.
37. Comperat E, Bardier-Dupas A, Camparo P, et al. Splenic metastases: clinicopathologic presentation, differential diagnosis, and pathogenesis. Arch Pathol Lab Med, 2007, 131(6): 965-969.
38. Piura B, Rabinovich A, Apel-Sarid LA. Splenic metastasis from endometrial carcinoma: report of a case and review of literature. Arch Gynecol Obstet, 2009, 280(6): 1001-1006.
39. Yang HY, Xu YK, Wu YK, et al. Superparamagnetic iron oxide: enhanced detection of splenic VX2 tumor with magnetic resonance imaging in rats. 中國組織工程研究與臨床康復, 2007, 11(44): 9001-9005.
40. Thompson WM, Levy AD, Aguilera NS, et al. Angiosarcoma of the spleen: Imaging characteristics in 12 patients. Radiology, 2005, 235(1): 106-115.
41. Qi R, Yu JQ, Xu H, et al. Primary angiosarcoma of the spleen as depicted on computed tomography. Clin Imaging, 2012, 36(5): 619-622.
42. Duan YF, Jiang Y, Wu CX, et al. Spontaneous rupture of primary splenic angiosarcoma: a case report and literature review.. World J Surg Oncol, 2013, 11: 53.
43. Lee J, Kim KW, Lee H, et al. Semiautomated spleen volumetry with diffusion-weighted MR imaging. Magn Reson Med, 2012, 68(1): 305-310.
44. Razek AA, Massoud SM, El-Bendary MM, et al. Prediction of esophageal varices in cirrhotic patients with apparent diffusion coefficient of the spleen. Abdom Imaging, 2015, 40(6): 1465-1469.
45. Shin SU, Lee JM, Yu MH, et al. Prediction of esophageal varices in patients with cirrhosis: usefulness of three-dimensional Mr elastography with echo-planar imaging technique. Radiology, 2014, 272(1): 143-153.
46. Ronot M, Lambert S, Elkrief L, et al. Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency Mr elastography in liver cirrhosis. Eur Radiol, 2014, 24(6): 1394-1402.
47. Hu X, Xu X, Zhang Q, et al. Indirect prediction of liver fibrosis by quantitative measurement of spleen stiffness using the FibroScan system. J Ultrasound Med, 2014, 33(1): 73-81.
48. 陶曉娟, 彭蕓, 呂艷秋, 等. 磁共振定量測定兒童及青少年戈謝病肝脾臟體積及脂質含量. 中國醫學影像技術, 2016, 32(7): 1080-1083.
49. Papakonstantinou O, Drakonaki EE, Maris TA, et al. Mr imaging of spleen in beta-thalassemia major. Abdom Imaging, 2015, 40(7): 2777-2782.
50. Casey J, Brewer BS, Thomas D, et al. Spleen R2 and R2*in Iron-Overloaded patients with sickle cell disease and thalassemia major. J Magn Reson Imaging, 2009, 29(2): 357-364.

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West China Medical Journal

脾臟病變CT/MRI診斷進展

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