胰腺少见肿瘤的CT诊断及鉴别诊断  

MSCT Diagnosis and Differentiation of Rare Pancreatic Tumors

作　　者：叶斌强 孙鹏飞[1] 曹向荣[1] 朱浩[1] 

机构地区：[1]兰州大学第二医院放射科,甘肃兰州730030

出　　处：《临床放射学杂志》2014年第5期726-729,共4页Journal of Clinical Radiology

摘　　要：目的分析胰腺少见肿瘤的CT表现,旨在提高其CT诊断及鉴别诊断水平。方法回顾性分析经手术病理证实的20例胰腺少见肿瘤的CT征象,包括肿瘤位置、形态、内部结构及邻近改变,评价各肿瘤间的影像学差异。结果 (1)肿瘤位置:头颈部15例,其中内分泌肿瘤7例、实性假乳头状瘤4例、浆液性囊腺瘤3例、黏液性囊腺瘤1例;体尾部5例,其中黏液性囊腺瘤2例、胰腺内分泌肿瘤2例、导管内乳头状黏液性肿瘤1例;(2)肿瘤形态:类球形结节或肿块19例,分叶状肿块1例;肿瘤边缘模糊、不光整者2例,其中恶性实性假乳头状瘤1例、胰腺低分化内分泌癌1例;(3)肿瘤内部结构:单囊或多囊病变7例,其中浆液性囊腺瘤3例、黏液性囊腺瘤3例、导管内乳头状黏液腺癌1例;囊实性病变4例,为实性假乳头状肿瘤;实性病变9例,均为胰腺内分泌肿瘤。结论胰腺少见肿瘤的部位、形态、内部结构及邻近表现有一定的特征性,仔细评价这些征象有助于与胰腺导管腺癌的鉴别诊断。Objective To analyze the CT manifestations of rare pancreatic tumors in order to improve their diagnosis and differentiation. Methods The CT features of 20 cases with pathologically-proved rare pancreatic tumors were retrospectively analyzed. The location, shape, inner structure of the tumors and the changes of the neighboring structures were recorded and the results were analyzed. Results （ 1 ） Fifteen tumors were located at the pancreatic head and neck, including pancreatic endocrine neoplasm （ n = 7 ） , solid pseudopapillary neoplasm （ n = 4 ） , serous cystic neoplasms （ n = 3 ） and mucinous cystic neoplasm （ n = 1 ）. Five tumors were located at the tail, including mneinous cystic neoplasms （ n = 2） , pancreatic endocrine neoplasm （ n = 2） and intraductal papillary adenocarcinoma （ n = 1 ）. （ 2 ） The tumors assumed spherical nodule or mass （n = 19 ） or a lobulated mass （n = 1 ） on CT scans. Blurred margin was seen in two lesions, in- cluding malignant solid pseudopapillary neoplasm （ n = 1 ） and poorly differentiated pancreatic endocrine cancer （ n = 1 ）. （3） Single or multiple cystic lesions were seen in 7 cases, including serous cystadenoma （ n = 3 ）, mucinous cystadenoma （ n = 3 ） and intraductal papillary adenocarcinoma （ n = 1 ）. Cystic-solid pseudopapillary neoplasm was confirmed in 4 cases and solid pancreatic endocrine neoplasm in 9 cases. Conclusion Rare pancreatic tumors carry certain CT imaging features in their location, shape, inner structure and neighboring structure changes, and careful evaluation of these signs isvery helpful in differentiating these tumors from pancreatic ductal adenocarcinomas.

关 键 词：胰腺肿瘤 体层摄影术 X线计算机 诊断 

分 类 号：R735.9[医药卫生—肿瘤]