胰腺囊实性乳头状瘤临床分析及CT、MRI诊断  

Clinical Analysis and CT and MRI Diagnosis of the Solid-Cystic Papillary Tumors of the Pancreas

作　　者：王田力[1] 郑英秋[1] 裴斐[2] 

机构地区：[1]北京大学第三医院放射科,北京100083 [2]北京大学医学部病理学系

出　　处：《实用放射学杂志》2008年第6期764-767,共4页Journal of Practical Radiology

摘　　要：目的探讨胰腺囊实性瘤(SCPTs)CT和MRI表现。方法经手术及病理证实SCPTs 8例,均经CT平扫及增强扫描,3例MRI检查,其中2例MRI增强扫描。结果肿瘤位于胰体、尾部7例,1例位于胰头部。肿瘤最大径平均7.6 cm。肿瘤界限清楚,包膜完整,CT平扫呈不均匀囊实性,实性结构为不规则状或呈乳头状,中心囊性部分密度较低。增强扫描肿瘤实性成分动脉期轻度强化,实质期呈中等或明显强化。肿瘤壳状及结节样钙化5例,1例肿瘤自发性破裂出血,1例胰管轻度扩张。MRI检查显示胰腺边缘清楚囊实性肿物,T1WI呈不均匀等-低混杂信号,1例瘤体内高信号,为亚急性出血。T2WI呈不均匀混杂高信号中,可见低信号区。增强扫描肿瘤实性和乳头状组织及囊壁强化。结论SCPTs具有一定的临床,CT及MRI影像学特点,可以帮助作出正确的诊断。Objective To investigate the CT and MRI features of solid - cystic papillary tumors （SCPTs） of the pancreas. Methods Eight cases of SCPTs confirmed by operation and pathology underwent both plain and contrast -enhanced CT examination, and MR examination in three cases and contrast - enhanced MRI in two cases. Results In the eight patients, the mean tumor diameter was 7.6 cm and the lesions were found mainly in the body and tail of the pancreas, only one at the pancreatic head. On plain CT scan, the tumors appeared as huge solid - cystic mass with definite margin and an integritied capsul,the solid areas were papillary or irregular components, and the cystic areas in central were low attenuation. On contrastenhanced CT, the cystic wall and solid part were slight enhancement in arterial phase, and moderate or obvious enhancement in parenchymal phase. Irregular ringed and punctate calcification could be seen in five cases,the acute hemorrhage occurred in one case, slight dilation of the pancreatic duct was noticed in one patient. MRI showed an ovoid solid -cystic mass of the pancreas with distinct border. On T1WI, heterogeneous iso - and hypo - intensity was observed. One case showing the high signal inten- sity in tumor was subacute hemorrhage. On T2WI, the tumors were mixed hypo - ,iso - and hyperintensity. The papillary or flocculent solid portion and the cystic wall were enhanced after gadolinium was used. Conclusion SCPTs is of certain clinic,CT and MRI characteristic findings,which can aid in reaching a proper diagnosis.

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] R814.42[医药卫生—临床医学]