Keywords:
Abdomen, Spleen, Oncology, CT, MR, Diagnostic procedure, Pathology, Cancer
Authors:
A. Abrishami1, S. Kooraki1, Y. Abrishami1, L. Grenacher2, H. U. Kauczor3; 1Tehran/IR, 2Munich/DE, 3Heidelberg/DE
DOI:
10.1594/ecr2018/C-1983
Results
Of 161 patients [54% males,
mean age (SD): 59.7 (15.4).
ranged: 8-88 yr.],
124 (77%) had benign lesions,
while 37 (23%) individuals were found out to have malignant lesion.
Benign lesions were more likely to be homogenous (59.7% vs.
29.7%,
p: 0.002).
(Table-1) Ill-defined and/or lobulated borders had significantly higher prevalence in malignant lesions (73% vs.
53.2%,
p: 0.03).
Malignant lesions had significantly larger size (21.7 vs.
15.5 mm,
p: 0.03).
None of the benign lesions showed restricted diffusion in DWI/ADC,
while 50% of malignant lesions had restriction (p: 0.003).
Lesion distribution,
Hounsfield Unit (HU) and enhancement pattern on imaging (Table-2) were not strong enough to differentiate benign from malignant lesions.
Hemangioma (Fig.1-2) and lymphoma (Fig.
3) were the most common lesions among two groups.
Table 1: Benign vs.
malignant splenic lesion characteristics on various MRI sequences
|
|
T1W
|
|
|
Blade
|
|
|
HASTE
|
|
|
Low
|
Iso
|
High
|
Low
|
Iso
|
High
|
Low
|
Iso
|
High
|
Benign
|
31(70.5%)
|
11(25.0%)
|
2(4.5%)
|
8(18.2%)
|
3(6.8%)
|
33(75%)
|
9(20.5%)
|
3(6.8%)
|
32(72.7%)
|
Malignant
|
9(81.8%)
|
1(9.1%)
|
1(9.1%)
|
4(36.4%)
|
1(9.1%)
|
6(54.5%)
|
4(36.4%)
|
1(9.1%)
|
6(54.5%)
|
Total
|
40(72.7%)
|
12(21.8%)
|
3(5.5%)
|
12(21.8%)
|
4(7.3%)
|
39(70.9%)
|
13(23.6%)
|
4(7.3%)
|
38(69.1%)
|
Table 2: Enhancement pattern of benign and malignant splenic lesions
|
Arterial
|
Portal
|
Delay
|
Spleen
|
Lesion
|
Difference
|
Spleen
|
Lesion
|
Difference
|
Spleen
|
Lesion
|
Difference
|
Benign
|
114.7(41.8)
|
60.4(52.9)
|
54.2(58.2)
|
108.5(22.0)
|
50.6(32.1)
|
57.9(34.4)
|
84.8(16.5)
|
59.0(45.6)
|
25.8(36.2)
|
Malignant
|
92.2(25.3)
|
40.7(19.6)
|
40.7(19.6)
|
105.8(18.9)
|
48.7(23.3)
|
57.0(25.1)
|
81.6(12.1)
|
41.1(16.9)
|
40.5(10.2)
|
P value
|
0.006
|
0.018
|
0.78
|
0.52
|
0.75
|
0.90
|
0.68
|
0.37
|
0.35
|