目的:用B型超声造影(CEUS)描述和分类脾脏囊性病变(S-CAL)。
方法:这项回顾性研究调查了2003年至2023年在跨学科超声中心使用B型超声检查的111例患者的S-CAL,彩色多普勒超声(CDS),和CEUS。S-CAL的特征是回声,直径,和形状,以及其他功能,如分隔,钙化,或壁增厚,和CDS/CEUS用于鉴定灌注。组织学检查或影像学随访对于确定S-CAL的性质是必要的。此外,定义了带有风险的\'S-CAL,需要进一步的程序。根据超声参数定义了四种类型(0-III)的S-CAL。Fisher精确检验用于比较非参数数据。
结果:111例患者的S-CAL(58例女性,53名男性-平均年龄:58.6岁)进行了检查。最终诊断为:脾囊肿(n=64,57.7%);脾脓肿(n=10,9.0%);脾内假性动脉瘤(n=10,9.0%);脾转移(n=10,9.0%);脾梗死(n=6,5.4%);脾血肿(n=4,3.6%);其他(n=7,6.3%)。S-CAL分组为0型(n=11,9.9%),I型(n=33,29.7%),II型(n=24,21.6%),和III型(n=43,38.7%)。有风险的\'S-CAL被诊断为n=41(36.9%)。恶性S-CAL仅见于II型(n=2,8.2%)和III型(n=9,20.9%)(p<0.001)。有风险的\'S-CAL在0型中更常见(n=11,100%),Ⅱ型(n=16,66.7%)和Ⅲ型(n=13,30.2%)比Ⅰ型(n=1,3%)(p<0.001)。
结论:B超,CDS,和CEUS可用于进一步表征和随访S-CAL,并识别具有风险的S-CAL,需要进一步的程序。
结论:超声成像对检测有价值,分类,和监测脾脏的囊性病变,以及识别有风险的人。
结论:S-CAL可能会在临床实践中引入不确定性,因为缺少基于影像学的风险分层。B模式和CEUS,随着临床背景和随访,协助表征和识别“有风险的S-CAL”。S-CAL包括各种病变,包括简单的囊肿,转移,脓肿,和脾内假性动脉瘤。
OBJECTIVE: To describe and categorize splenic cystic-appearing lesions (S-CAL) with B-mode and contrast-enhanced ultrasound (CEUS).
METHODS: This retrospective study investigated S-CALs in 111 patients between 2003 and 2023 in an interdisciplinary ultrasound center with B-mode ultrasound, color Doppler sonography (CDS), and CEUS. S-CAL was characterized by echogenicity, diameter, and shape, as well as additional features like septation, calcification, or wall thickening, and CDS/CEUS were used to identify perfusion. Histological examination or imaging follow-up was necessary to determine the nature of S-CAL. Moreover, \'S-CAL with risk\' was defined, necessitating further procedures. Four types (0-III) of S-CALs were defined based on ultrasound parameters. Fisher\'s exact test was used to compare non-parametric data.
RESULTS: S-CAL of 111 patients (58 female, 53 men-average age: 58.6 years) was examined. Final diagnoses were: splenic cyst (n = 64, 57.7%); splenic abscess (n = 10, 9.0%); intrasplenic pseudoaneurysm (n = 10, 9.0%); splenic metastasis (n = 10, 9.0%); splenic infarction (n = 6, 5.4%); splenic hematoma (n = 4, 3.6%); other (n = 7, 6.3%). S-CAL groupings were type 0 (n = 11, 9.9%), type I (n = 33, 29.7%), type II (n = 24, 21.6%), and type III (n = 43, 38.7%). \'S-CAL with risk\' was diagnosed in n = 41 (36.9%). Malignant S-CAL was only seen in type II (n = 2, 8.2%) and type III (n = 9, 20.9%) (p < 0.001). \'S-CALs with risk\' were found more frequently in type 0 (n = 11, 100%), type II (n = 16, 66.7%) and type III (n = 13, 30.2%) than in type I (n = 1, 3%) (p < 0.001).
CONCLUSIONS: B-mode ultrasound, CDS, and CEUS are useful to further characterize and follow-up S-CAL and identify \'S-CAL with risk\', requiring further procedures.
CONCLUSIONS: Ultrasound imaging is valuable for the detection, categorization, and monitoring of cystic-appearing lesions of the spleen, as well as for the identification of those with risk.
CONCLUSIONS: An S-CAL may introduce uncertainty in clinical practice as imaging-based risk stratification is missing. B-mode and CEUS, along with the clinical context and follow-up, assist in characterizing and identifying \'S-CAL with risk\'. S-CALs encompass various lesions, including simple cysts, metastases, abscesses, and intrasplenic pseudoaneurysms.