胰腺实性假乳头状瘤典型与非典型的CT及MR表现  

The Solid Pseudopapillary Tumor of Pancreas:Typical and Atypical Manifestationsons on CT and MRI

作　　者：黄建军[1] 姚秀忠[2] 张兰慧[1] 

机构地区：[1]安徽中医学院第一附属医院影像中心,安徽230031 [2]复旦大学附属中山医院放射科,上海200032

出　　处：《中国CT和MRI杂志》2014年第4期34-38,共5页Chinese Journal of CT and MRI

摘　　要：目的分析胰腺实性假乳头状瘤(SPTP)的典型与非典型CT与MT表现,提高对其术前诊断的准确率。材料和方法回顾性分析手术后病理诊断SPTP49例,其中CT28例,MRI22例,有8例同时行CT与MRI检查。分析患者年龄、性别、肿瘤大小、位置及影像表现。结果本组患者发病年龄为13-64岁,平均年龄31.4岁,男女比为1:3.46,其中年轻女性29例(小于等于40岁,59.2%),老龄女性9例(大于40岁18.4%),男性11例(22.4%)。肿瘤最大直径为0.8-10.5cm,平均4.9cm,最大径大于5cm有21(42%)例,3cm至5cm之间有16(32%)例,小于3cm有13(26%)例。48例为单发,1例多发,病灶位于胰腺钩突部3例,头部13例,头颈部1例,颈部8例,体部10例,体尾部9例,尾部6例。SPTP典型的CT与MRI表现为单发不均质囊实性肿块,有包膜易出血,增强后动脉期实性部分轻中度强化,呈渐进性延迟强化,本组分别约占92.6%与95.5%。非典型SPTP影像表现主要为肿块的恶性生长方式与动脉早期明显强化,本组有4例肿瘤侵犯邻近结构,1例肝转移,胰管轻度扩张2例,胆总管轻度扩张1例;CT与MRI检查动脉期早期明显强化分约占7.4%,4.5%。结论典型的SPTP影像学表现特征性明显,CT与MRI诊断容易,而非典型的SPTP容易术前误诊,但其影像表现亦有一定特征性。Objectives To analyze typical and atypical imaging appearances of solid pseudopapillary tumor of the pancreas（SPTP）and improve the diagnostic accuracy before operation. MaterialsandMethods Retrospective analysis of 49 cases of SPTP approved by pathological diagnosis, including 28 patients with CT examination, 22 with MRI examination and 8 underwent both CT and MRI. The age, gender, tumor size, location, and imaging findings were analyzed. Results For 49 patients, the ratio of female（38 cases,77.6%） to male（11cases,22.4%） was 3.46 and the age range was 13-64 years with an average of 31.4. Among 38 female patients, 29 women were younger than 40 years old and other 9 women were older than 40 years. The range of maximum diameter for tumors was 0.8-10.5cm with an average of 4.9cm,including 21（42%） cases with the maximum diameter greater than 5cm,16（32%）cases between 3cm to 5cm and 13（26%） cases less than 3cm.48 cases were single and one case was multiple, including 3 cases located in the uncinate process of pancreas, 13 cases in the head of pancreas,1 case located in pancreatic head and neck, 8 cases in the neck of pancreas, 10 cases in the body of pancreas, 9 cases in the part of pancreatic body and tail, 6 cases in the tail of pancreas. The imaging demonstrations for typical SPTP were a large well-encapsulated, varying solid-cystic mass with areas of hemorrhagic degeneration and early peripheral heterogeneous enhancement with progressive fill-in on dynamic examination after contrast agent administration. For this group, typical SPTP accounted for about 92.6% in CT and 95.5% in MRI. Atypical SPTP grew in a malignant tumor type and significantly enhanced on early arterial phase, including four tumors with invasion of adjacent structures, one case with liver metastasis, and mild dilation of pancreatic duct in two cases and common bile duct in one case, and significant enhancement on arterial phase for about 7.4%cases on CT and 4.5%on MRI. Conclusions Imaging performance for typical SPTP have cha

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]