胰腺实性假乳头状瘤影像学诊断与病理对照分析  

Solid Pseudopapillary Tumor of the Pancreas:Correlation of Imaging Appearances vs Pathological Findings

作　　者：史讯[1] 曾蒙苏[1] 张志勇[1] 靳大勇[2] 楼文辉[2] 纪元[3] 

机构地区：[1]复旦大学附属中山医院放射科 [2]复旦大学附属中山医院胰腺外科,上海200032 [3]复旦大学附属中山医院病理科,上海200032

出　　处：《放射学实践》2006年第11期1162-1165,共4页Radiologic Practice

摘　　要：目的：分析胰腺实性假乳头状瘤（SPTP）影像学表现，并与病理学对照，旨在提高对该病的认识及诊断水平。方法：回顾性分析13例经手术及病理证实的胰腺实性假乳头状瘤的临床、CT和MRI资料，将影像学表现与手术病理结果对照。结果：SPTP好发于20～40岁女性，胰尾、胰头为好发部位。影像学多表现为境界清晰的圆形、类圆形胰腺肿块，瘤体通常较大（≥5cm）。平扫主要表现为囊实性混杂密度／信号，实性结构边缘分布为主，部分呈乳头状或壁结节样突起。动态增强后实性部分早期轻度强化，后期呈渐进性强化。13例肿瘤均有包膜，多伴有出血及囊变，出血在MRI上多呈现为特征性的“分层现象”。所有病灶无论其大小及在胰腺所处位置，均未见胆管、胰管扩张，罕见腹腔淋巴结肿大及远处脏器转移。结论：胰腺实性假乳头状瘤影像学表现具有相对特征性，CT和MRI对其诊断有重要价值，其中MRI在显示病灶出血、囊变、包膜方面更具优势。Objective：To demonstrate the imaging features of solid pseudopapillary tumor of the pancreas （SPTP）, and to correlate the imaging appearances with the pathological findings so as to enhance the imaging diagnostics of the disease. Methods：Thirteen cases of pathologically proven SPTP were included in this retrospective article. Imaging features were compared with pathological results. Results.. The disease mainly occurred in females aged between 20 -40 years old. Pancreatic tail and head were the prevailing sites of tumor involvement. On CT/MRI, the lesions presented as well-defined round and oval shaped masses （≥5cm）. On non-enhanced CT/MRI, the lesions appeared as heterogeneous density/signal intensity masses because of their components consisting of solid and cystic ones. The solid portions of the tumor were often located at the periphery of the masses, and some of them showed the shapes of nipple or mural nodular processes. After contrast administration, the lesions demonstrated mild peripheral heterogeneous enhancement in arterial phase with progressing filling-in during the later phases. All tumors possessed capsules. Some of the tumors involved intratumoral hemorrhage and cystic degeneration, the former revealed a characteristic sign of fluid-fluid levels on MRI. In our series of SPTP, regardless of the size and location of the tumors,neither dilatation of biliary tract nor pancreatic ducts were found probably because of the tenderness of the tumors. Metastatic adenopathy of abdominal cavity and remote metastasis of lymph nodes were rare. Conclusion.. Certain imaging diagnostic characteristics of SPTP were demonstrated with CT and MRI, and MRI was more ef- fective in displaying hemorrhage,cystic degeneration and capsules of the lesions than CT.

关 键 词：胰腺肿瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R735.9[医药卫生—肿瘤]