Mainenti P P, Camera L, Nicotra S, Cantalupo T, Soscia E, Di Vizio D, Insabato G, Salvatore M
IBB, University Federico II, Naples, Italy.
Abdom Imaging. 2005 Nov-Dec;30(6):768-72. doi: 10.1007/s00261-005-0317-5. Epub 2005 Aug 11.
The spleen is frequently involved in systemic amyloidosis; however, the computed tomographic (CT) or magnetic resonance (MR) pattern of splenic amyloidosis is not sufficiently described in the literature. This study evaluated the contrast-enhanced CT and MR findings of the spleen in patients with systemic amyloidosis.
Data were extracted by reviewing pathology and radiology department records of the teaching hospital of Naples over 10 years, from 1 January 1993 to 31 December 2002. Thirty-three patients with amyloidosis were identified, 10 of whom had a CT scan and two of whom had an MR study. The population-based study was composed of 12 patients with histologically proved amyloidosis who underwent contrast-enhanced CT or MR scan of the abdomen. The spleen and liver were evaluated for organ size and perfusion.
The spleen was hypoperfused in nine of 12 patients. Mild splenomegaly was present in only one case. Hepatomegaly was associated with markedly acute left lobe margin in nine patients and with rounded anterior profile of segments 3 and 4 in four patients. Moreover, a large area of low attenuation with indefinite geographic margins involving the right hepatic lobe was observed in three patients.
The finding of splenic hypoperfusion may be a marker of systemic amyloidosis, which represents a useful clue when clinical findings fail to suggest the proper diagnosis.
脾脏常累及系统性淀粉样变性；然而，脾脏淀粉样变性的计算机断层扫描（CT）或磁共振成像（MR）表现，在文献中并未得到充分描述。本研究评估了系统性淀粉样变性患者脾脏的对比增强CT和MR表现。
通过回顾那不勒斯教学医院1993年1月1日至2002年12月31日这10年间的病理科和放射科记录来提取数据。确定了33例淀粉样变性患者，其中10例进行了CT扫描，2例进行了MR检查。这项基于人群的研究由12例经组织学证实为淀粉样变性且接受了腹部对比增强CT或MR扫描的患者组成。对脾脏和肝脏的器官大小及灌注情况进行评估。
12例患者中有9例脾脏灌注不足。仅1例存在轻度脾肿大。9例患者肝脏肿大伴有明显的左叶急性边缘，4例患者伴有第3和第4段的圆形前缘。此外，3例患者右肝叶可见大片边界不清的低密度区。
脾脏灌注不足这一表现可能是系统性淀粉样变性的一个标志，当临床表现无法提示正确诊断时，它是一个有用的线索。
