Hahn P F, Weissleder R, Stark D D, Saini S, Elizondo G, Ferrucci J T
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
AJR Am J Roentgenol. 1988 Apr;150(4):823-7. doi: 10.2214/ajr.150.4.823.
This study was undertaken to define the MR appearance of splenic tumors in 16 cancer patients with focal splenic lesions; 50 volunteers and liver cancer patients without splenic abnormalities served as controls. In 14 patients with focal splenic lesions, differences between splenic and lesion signal intensities permitted detection of splenic lesions on MR images, either because of cystic or necrotic areas lengthening T2 within the tumor, because of T1 shortening from tumor-associated hemorrhage, or because of T2 shortening of surrounding spleen in two cases of suspected transfusional iron overload. In one spleen, a lesion appeared isointense on both T1- and T2-weighted pulse sequences and was detected only by gross splenic deformity. In one other case, CT defined splenic metastases not visible on MR images. Measurements of signal intensity of normal spleens and tumor are so similar that spin-echo MR imaging can underestimate the size and extent of focal splenic disease or may miss lesions entirely. We conclude that MR imaging is a less sensitive technique for detecting focal lesions of the spleen than for detecting focal hepatic lesions.
本研究旨在明确16例患有局灶性脾病变的癌症患者脾脏肿瘤的磁共振成像（MR）表现；50名志愿者及无脾脏异常的肝癌患者作为对照。在14例患有局灶性脾病变的患者中，脾脏与病变信号强度的差异使得在MR图像上能够检测到脾病变，这要么是由于肿瘤内的囊性或坏死区域延长了T2，要么是由于肿瘤相关出血导致T1缩短，要么是在两例疑似输血性铁过载的病例中由于周围脾脏的T2缩短。在一个脾脏中，一个病变在T1加权和T2加权脉冲序列上均表现为等信号，仅通过脾脏的大体变形才被检测到。在另一例病例中，CT显示了MR图像上不可见的脾转移瘤。正常脾脏和肿瘤的信号强度测量值非常相似，以至于自旋回波MR成像可能会低估局灶性脾疾病的大小和范围，或者可能完全漏诊病变。我们得出结论，与检测局灶性肝病变相比，MR成像检测脾脏局灶性病变的技术敏感性较低。
