胰腺腺泡细胞癌的 CT 和 MRI 诊断  

CT and MRI diagnosis of pancreatic acinar cell carcinoma

作　　者：玄飞 丁玉芹[2] 何德明[3] 周建军[2] 

机构地区：[1]山东省潍坊市中医院影像中心,山东潍坊261041 [2]上海复旦大学附属中山医院放射科 [3]上海复旦大学附属中山医院病理科

出　　处：《实用放射学杂志》2014年第7期1150-1153,共4页Journal of Practical Radiology

摘　　要：目的：探讨胰腺腺泡细胞癌（PACC）的影像表现,评价 CT 和 MRI 对该病的诊断价值。方法回顾性分析7例经手术病理证实的胰腺腺泡细胞癌的 CT 和 MRI 表现。4例行 CT 平扫和动态增强扫描,3例行 MR T1 WI、T2 WI 和动态增强扫描。结果胰腺腺泡细胞癌均为单发肿瘤,肿瘤位于胰头区1例,胰体尾区6例。影像表现：CT 平扫4例病灶均为稍低密度,其中3例病灶内部见不规则更低密度影,增强后动脉期所有病灶实质部分均有轻中度强化,病灶内有无强化的低密度区,门脉期及延迟期渐进性强化,强化程度低或稍低于正常胰腺组织。MRI T1 WI 为混杂略低信号,T2 WI 为混杂略高信号,动态增强后,实性部分强化,强化程度低于正常胰腺组织。其中伴远端胰管扩张4例,肝转移1例,周围组织侵犯4例。结论 CT 和MRI 可显示胰腺腺泡细胞癌的特征性表现,有助于提高该病的诊断准确性。Objective To investigate the imaging features of pancreatic acinar cell carcinoma （PACC）,and to assess the role of CT and MRI in the diagnosis of the disease.Methods CT and MRI data of 7 cases with PACC confirmed by surgery and pathology were reviewed retrospectively.Plan and dynamic contrast-enhanced CT were performed in 4 cases.MRI with T1 WI,T2 WI,and dy-namic contrast-enhanced series were performed in 3 cases.Results All of the PACC lesions were manifested as a single solitary mass.1 lesion was located in the pancreatic head,and the other 6 in the pancreatic body-tail.On plan CT,all of the 4 lesions ap-peared hypodense and 3 lesions had irregular more hypodense region in the lesions.On the contrast-enhanced CT,the tumor paren-chyma showed mild to moderate enhancement with non-enhanced hypodense region in the arterial phase,and lower enhancement than that of the surrounding normal pancreatic tissue in the portal and delayed phase.All of the 3 cases were heterogeneous hypointensity on T1 WI and hyperintensity on T2 WI.The manifestations of the tumors on contrast-enhanced MRI were similar with that on the contrast-enhanced CT.Dilation of the pancreatic duct was seen in 4 cases.Liver metastasis was seen in 1 case.Surrounding tissues were invaded in 4 cases.Conclusion CT and MRI can display the features of PACC and help to improve the diagnostic accuracy.

关 键 词：胰腺肿瘤 腺泡细胞癌 计算机体层成像 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]