Department of Radiology, Shanghai Pudong New Area People's Hospital, Shanghai, China
Department of Radiology, ZhongShan Hospital, Fudan University, Shanghai, China
Curr Med Imaging. 2024;20:e260423216201. doi: 10.2174/1573405620666230426122828.
The objective of this study was to describe the CT and MRI features of sclerosing angiomatoid nodular transformation (SANT) of the spleen with pathologic correlation.
Ten patients with surgically resected and pathologically confirmed SANTs were included. Clinical history was reviewed, and gross pathologic, histologic, and immunohistochemical findings were recorded. CT and MRI examinations were evaluated by two radiologists.
Patients included seven men and three women, with a mean age of 42.9±16.7 years. Pathologic features of SANTs involved multiple angiomatous nodules in a radiating pattern with a central stellate fibrous scar and evidence of hemosiderin deposition. 9 cases showed a lobulated demarcated margin, 8 cases a slight hypoattenuating, 1 isoattenuating, and 1 case with two lesions demonstrated a slight hyperattenuating margin, respectively. Multiple scattered punctate calcifications were involved in 2 cases. 5 cases manifested hypointensity on in-phase imaging, 1 iso-intensity, and 4 iso-hypointensity on out-of-phase imaging. Progressive and centripetal enhancement were exhibited in 10 cases, spoke-wheel pattern in 3 cases, and nodular enhancement in 4 cases, respectively. The central fibrous scar was identified in 8 cases during delayed enhancement.
Characteristics of SANTs on CT/MRI reflected the underlying pathology. Hypointensity on DWI and T2WI, and change of signal on T1 chemicalshift imaging were found to be due to hemosiderin deposition and fibrous tissue. Typical feature was a solitary, round, lobulated mass with a fibrous scar. Progressive and centripetal enhancement, spoke-wheel pattern, nodular enhancement, and delayed enhancement of central fibrous scar were observed.
本研究的目的是描述与病理相关的脾脏硬化性血管瘤样结节转化（SANT）的 CT 和 MRI 特征。
纳入 10 例经手术切除和病理证实的 SANT 患者。回顾临床病史，并记录大体病理、组织学和免疫组织化学发现。由两名放射科医生评估 CT 和 MRI 检查结果。
患者包括 7 名男性和 3 名女性，平均年龄为 42.9±16.7 岁。SANT 的病理特征涉及放射状排列的多个血管瘤结节，中央呈星状纤维瘢痕，并伴有含铁血黄素沉积的证据。9 例表现为分叶状边界清楚，8 例轻度低衰减，1 例等衰减，1 例有 2 个病变表现为轻微高衰减边界，分别。2 例涉及多个散在点状钙化。5 例在同相位成像上呈低信号，1 例等信号，4 例低信号。10 例表现为渐进性和向心性强化，3 例呈辐轮状强化，4 例呈结节状强化。8 例在延迟强化时可识别中央纤维瘢痕。
CT/MRI 上的 SANT 特征反映了潜在的病理学。DWI 和 T2WI 上的低信号以及 T1 化学位移成像上的信号变化被认为是由于含铁血黄素沉积和纤维组织所致。典型特征是孤立的、圆形的、分叶状肿块伴纤维瘢痕。观察到渐进性和向心性强化、辐轮状强化、结节状强化和中央纤维瘢痕的延迟强化。
