胰腺实性假乳头状瘤的超声影像所见及与解剖病理学的相关性  

Study on sonography imaging of solid pseudopapillary tumor of the pancreas,and its relation to anatomy and pathology

作　　者：周爱香[1] 赵伟[2] 初霞[2] 董桂云 宫璀璀[4] 李保田[5] 李成群[6] 

机构地区：[1]解放军153医院特检科,河南郑州450042 [2]解放军153医院病理科,河南郑州450042 [3]解放军159医院特检科,河南驻马店463000 [4]解放军153医院检验科,河南郑州450042 [5]解放军153医院胸心外科,河南郑州450042 [6]解放军153医院放射科,河南郑州450042

出　　处：《实用医药杂志》2014年第9期775-777,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的 探讨胰腺实性假乳头状瘤（SPTP）的影像学、解剖学及病理学特征,提高对该病的认识及超声诊断水平。方法 分析11例SPTP的超声表现和解剖、病理学特征。结果 11例SPTP均为单发、圆形或椭圆形实性不均质稍低回声团。9例肿瘤边界清楚、8例包膜完整,10例瘤后回声无衰减,9例相邻组织器官受压、移位。2例瘤内或周边弧形、斑点状强回声后伴声影。除1例胰头SPTP远端胰管略宽（0。3 cm）外,余患者胆管、胰管均无扩张。8例瘤内及周边示少许血流信号,脉冲多普勒（PW）检测最大血流速度（Vmax）为11。8-52。6 cm/s,平均为26。6 cm/s,阻力指数（RI）为0。45-0。68,平均为0。48。本组患者均经手术、病理证实。肿瘤边界清晰、包膜较完整者瘤外有一厚薄不均的纤维包膜,供瘤血管较丰富;切面为囊性区与实性区以不同比例组成,实性区由单一肿瘤细胞围绕血管排列呈巢状或片块状,假乳头区以纤维血管为轴心形成分支状假乳头,局部常见出血、坏死、囊变、钙化或形成胆固醇样肉芽增生等。结论 SPTP的超声表现与解剖病理学有较好的一致性,其病理学特点是超声影像的基础。Objective To study the characteristics of sonographie,anatomy and pathology of solid pseudopapillary tumor （SPTP） of the pancreas,so as to improve the understanding and diagnostic level of the disease by ultrasound. Methods Ultrasound manifestations,anatomy and pathological feature of llcases with SPTP were analysed. Results The 11 eases were all single mass with round or oval shape and with solid or mixed slightly low echo,among them 9 cases had clear boundary,8 had complete capsule （8/11）,10 showed no post- tumoreeho attenuation,9 showed adjacent tissues or organs as compression or shift,2 showed tumors in and around as arc or speckled echogenic with acoustic shadow;Except for 1 case showed slightly widen of distal pancreatic duct of SPTP in the head of pancreas（3.0mm）,the other cases no dilatation in the pancrestic duct and bile duct; 8 showed tumors in and around as little blood flow. Pulse Doppler （PW） detected the aximum blood flow velocity （Vmax） was ll.8-52.6cm/s （averaged 26.6cm/s）,the resistance index （RI） was 0.45-0.68 （averaged 0.48）. The above cases were confirmed by operation and pathology：the tumor being with clear boundary and intact envelop had an uneven thickness fibrous capsule. Surface of tumor had richer support vessels,its section was the mixture of cystic and solid area at different ratio. Solid area was made from a single tumor cells rounding vascular vessels and arranging as nests or patches ;False nipple area was of fiber vascular vessels as axis for formating branch-like falsenipple,its local sites showed hemorrhage,necrosis,cystic change,calcification or formation of cholesterol-like granulation hyperplasia etc. Conclusion Uhrasonography and anatomic pathology of SPTP have good consistency, its pathological characteristics is the basis for ultrasonic diagnosis.

关 键 词：胰腺 假乳头状瘤 超声影像学 解剖学 病理学 

分 类 号：R735.9[医药卫生—肿瘤]