From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252 (L.W.N., M.G.L., P.J.P.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (S.M.B., S.B.); and American College of Radiology (ACR) Institute for Radiologic Pathology (AIRP), Silver Spring, Md (M.G.L., P.J.P.).
Radiographics. 2024 Nov;44(11):e240004. doi: 10.1148/rg.240004.
A spectrum of heterotopic and ectopic splenic conditions may be encountered in clinical practice as incidental asymptomatic detection or symptomatic diagnosis. The radiologist needs to be aware of these conditions and their imaging characteristics to provide a prompt correct diagnosis and avoid misdiagnosis as neoplasm or lymphadenopathy. Having a strong knowledge base of the embryologic development of the spleen improves understanding of the pathophysiologic basis of these conditions. Spleen-specific imaging techniques-such as technetium 99m (Tc)-labeled denatured erythrocyte scintigraphy, Tc-sulfur colloid liver-spleen scintigraphy, and MRI with ferumoxytol intravenous contrast material-can also be used to confirm the presence or absence of splenic tissue. Heterotopic splenic conditions include splenules and splenogonadal fusion (discontinuous or continuous forms). These heterotopic conditions are caused by incomplete fusion of the splenic primordia (splenule) and abnormal fusion of the gonadal and splenic tissue (splenogonadal fusion). Ectopic splenic conditions arise in patients with a prior splenic injury (splenosis), laxity or maldevelopment of the splenic ligaments (wandering spleen), or heterotaxy syndromes (polysplenia and asplenia). Importantly, these heterotopic and ectopic splenic conditions can also manifest with complications, including vascular torsion and rupture. RSNA, 2024.
在临床实践中，可能会偶然发现无症状的或有症状的各种异位和副脾情况。放射科医生需要了解这些情况及其影像学特征，以便能够迅速准确地做出诊断，避免误诊为肿瘤或淋巴结病。深入了解脾脏的胚胎发育有助于理解这些情况的病理生理基础。脾脏特异性成像技术，如锝 99m（Tc）标记变性红细胞闪烁扫描、Tc 硫胶体肝脾闪烁扫描和使用铁载氧体的 MRI，也可用于确认是否存在脾组织。异位脾情况包括脾小结和脾性腺融合（连续或不连续形式）。这些异位情况是由于脾原基（脾小结）融合不完全和性腺与脾组织异常融合（脾性腺融合）所致。脾副脾发生于脾损伤（脾种植）、脾韧带松弛或发育不良（游走脾）或异位轴综合征（多脾和无脾）的患者中。重要的是，这些异位和副脾情况也可能出现并发症，包括血管扭转和破裂。RSNA，2024。
