Caslowitz P L, Labs J D, Fishman E K, Siegelman S S
Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Comput Med Imaging Graph. 1990 Mar-Apr;14(2):133-41. doi: 10.1016/s0895-6111(05)80048-5.
Fifty-nine cases of nontraumatic splenic disease were reviewed to evaluate the roles of clinical findings, computed tomography, ultrasound, and radionuclide scanning in diagnosis and management. Patient groups included lymphoma (30 patients), infarct (11 patients), abscess (9 patients), cyst (5 patients), hemangioma (3 patients), and hamartoma (1 patient). In no case were clinical findings alone sufficient to diagnose a splenic lesion. Clinical and laboratory manifestations were nonspecific in all groups. Moreover, no radiologic study reliably diagnosed splenic lymphoma or leukemia. All other focal splenic lesions were consistently diagnosed noninvasively. Cross-sectional imaging was more useful than radioisotope scanning, and often provided adjunctive diagnosis of extrasplenic pathology. The superior detail, spatial resolution, and sensitivity of computed tomography made it the single most valuable diagnostic modality.
回顾了59例非创伤性脾脏疾病病例，以评估临床检查结果、计算机断层扫描（CT）、超声和放射性核素扫描在诊断和治疗中的作用。患者组包括淋巴瘤（30例）、梗死（11例）、脓肿（9例）、囊肿（5例）、血管瘤（3例）和错构瘤（1例）。在任何情况下，仅临床检查结果都不足以诊断脾脏病变。所有组的临床和实验室表现均无特异性。此外，没有任何影像学检查能可靠地诊断脾脏淋巴瘤或白血病。所有其他局灶性脾脏病变均能通过非侵入性方法得到一致诊断。横断面成像比放射性核素扫描更有用，并且常常能辅助诊断脾外病变。计算机断层扫描的细节、空间分辨率和敏感性更优，使其成为最有价值的单一诊断方法。
