胰腺实性假乳头状瘤的影像学诊断  

Imaging diagnosis of solid-pseudopapillary tumors of pancreas

作　　者：杨大为[1] 杨正汉[1] 李惠章[1] 胡荣剑[1] 张永春[1] 周诚[1] 

机构地区：[1]卫生部北京医院放射科,北京100730

出　　处：《医学影像学杂志》2008年第5期514-517,共4页Journal of Medical Imaging

摘　　要：目的：研究胰腺实性假乳头状瘤的影像学表现，提高对该病的认识诊断水平。方法：回顾性收集7例经手术病理证实的胰腺实性假乳头状瘤，5例女性，2例男性，发病年龄为17—46岁。3例行CT和US检查，1例行CT和MR检查，2例单独行CT检查，1例单独行US检查。分析其临床特征及CT、MR、US表现。结果：7例胰腺实性假乳头状瘤中，1例诊断为恶性，6例诊断为未定性。6例未定性中，1例于术后半年复查发现肿瘤复发及肝转移。CT均表现为巨大的囊实性肿块，其中2例可见钙化，增强扫描后，肿块囊壁与实性成分不均匀强化，出血坏死区无强化。MR可见肿块在T1WI、T2WI上呈不均匀混杂信号，能识别肿瘤内部的坏死囊变及出血等特异性征象。US可见肿块呈孤立性、囊实性结构，边界清楚锐利，有包膜回声。肿块周边及实质内可探及血流信号，以静脉血流为主。结论：胰腺实性假乳头状瘤影像学表现较具特征性，结合临床特征对术前诊断很有帮助。Objectlve：The aim of tiffs study was to investigate the imaging findings of solid-pseudopillary tumors of pancreas（SFTP） and to improve the ability for the diagnosisis of the disease.Methods：7 patients with pathologically proved SFTP including five females and 2 males were retrospectively analyzed. CT and US were performed on 3 of 7 patients preoperatively. CT and unenhanced MRI were performed on 1 patient preoperatively. Another patient and other 2 patients underwent US and CT,respectively. Both clinical characteristics and imaging findings were analyzed retrospectively. Results： 1 patient had malignant SPTP proved pathologically. The other 6 patients were unidentified, in which 1 patient got tumor recurrence and liver metastasis in half a year after operation. All SFTP were manifested as giant solid-cystic mass in the head or tail of pancreas on CT scan; in 2 of 7 patients, calcification was found in the mass centrally or peripherally. On enhanced CT images, the solid part and capsule wall were heterogeneously enhanced, while, the hemorrhagic or necrotic regions remained unchanged, SPTP in 1 patient demonstrated heterogenous signal intensity on T1WI and T2WI and hemorrhagic,necrotic or cystic portions could be clearly identified. On uhrasonographic images, an isolated well-defined cystic-solid mass could be found. Color Doppler blood flow signals （mainly venous blood flow）could be seen inside and around the tumor. Conclusion： CT, MRI and US findings of solid-pseudopapillary tumor of pancreas are characteristic and, combining imaging findings with the unique clinical features, the disease can be preoperatively diagnosed.

关 键 词：胰腺肿瘤 体层摄像术 X线计算机 

分 类 号：R735.9[医药卫生—肿瘤] R814.42[医药卫生—临床医学]