The imaging findings of unexpected splenic autotransplantation after splenectomy / 中华肝胆外科杂志

ABSTRACT

Objective To study the imaging findings of unexpected splenic autotransplantation after splenectomy and to improve diagnostic accuracy of splenic autotransplantation.Methods The findings of 10 patients with splenic autotransplantation confirmed by histology in our hospital were retrospectively reviewed.In 7 patients CT and plain and dynamic enhanced MRI scanning were carried out,and in 2 of them 99mTc-DRBC scanning were also done.In 3 patients,plain and dynamic enhanced CT scannings were done.Results (1) Multiple lesions were detected in 7 patients and a single lesion in 3 patients.The masses were round and oval.The nodules were in the splenic fossa in 9 patients,in the pancreatic tail in 4 patients,in the right liver in 2 patients and in other of parts of the abdominal cavity in 2 patients.These nodules varied in size and 94.6％ showed a maximum diameter of less than 3 cm; (2) The findings on CT and MRall the nodules were homogeneous with soft tissue density.There was no cystic degeneration,necrosis and calcification.In one patient with a nodule in the pancreatic tail,there was a slightly short T1 and short T2 signals.Other nodules showed long T1 and long T2 signals.All the signals from the nodules were homogeneous and their outlines were clear.In a patient with a nodule in the right liver,the blood supply came from the abdominal aorta.There was a surrounding thin layer of low-density ring which showed long T1 and long T2 signals.The enhanced features on CT and MR were similar.The nodules showed homogeneous or inhomogeneous enhancement in the arterial phase,with continuous homogeneous enhancement in the portal venous phase,with an obvious decline in the delayed phase;(3) The findings of 18 F-FDG PETThe nodules had obvious increase in FDG uptake.Conclusions In patients with a history of splenic trauma or splenectomy,abdominal nodules with multiple,homogeneous density or signal,clear outline,enhanced features similar to spleen,splenic autotransplantation should be considered.99mTc-DRBC scanning is helpful in the diagnosis of splenic autotransplantation.