胰腺实性假乳头状瘤的MSCT表现及鉴别  

Multi-slice spiral CT findings and differential diagnosis of solid-pseudopapillary tumor of pancreas

作　　者：赖伟[1] 刘建新[1] 黄坤[2] 谢金荣 李子平[2] 彭振鹏[2] 

机构地区：[1]广东医学院附属东莞市第八人民医院放射科,广东东莞523325 [2]中山大学附属第一医院放射科,广东广州510080 [3]德宏州人民医院影像科,云南芒市678400

出　　处：《影像诊断与介入放射学》2015年第3期190-194,共5页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨胰腺实性假乳头状瘤(SPTP)的多层螺旋CT(MSCT)表现及鉴别诊断,提高对该病的认识。方法回顾性分析34例经手术、穿刺及病理证实的SPTP的临床及MSCT资料。结果胰头部10例(1例并发肝脏转移),胰头-颈部4例,胰颈部6例,胰体部2例,胰体-尾部6例(1例发生肝脏及腹腔转移),胰尾部6例。30例肿瘤最大径大于30mm,4例小于等于30 mm。肿块呈类圆形25例,分叶状9例。实性成分为主型9例,囊实型20例,囊性成分为主型5例。14例肿瘤钙化。胰管扩张12例,3例并胆总管扩张。实性部分CT平扫呈等、稍低密度,增强扫描动脉期轻度至明显强化,静脉期及延时期呈持续强化,但强化程度始终低于正常胰腺组织。囊性部分平扫为低密度,增强扫描无强化。30例包膜完整,4例包膜不完整。2例发生转移,3例具有恶性行为。术前诊断正确28例,误诊6例。结论 SPTP最多见于年轻女性患者,也可见于男性、老年人及儿童,并可恶变致腹腔、肝脏转移。SPTP的CT表现有一定特征,结合临床表现,大多可在术前作出准确诊断。Objective To investigate the MSCT features and differential diagnosis of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods The clinical and MSCT features of 34 patients with pathologically proven SPTP were retrospectively analyzed. Results The tumors were located in the pancreatic head（10）, head-neck（4）, neck（6）, body（2）, body-tail（6）,or tail（6） measuring 〉3 cm（30） or ≤3 cm（4）. The SPTP was round（25） or lobulated（9）; solid（9）, cystic-solid（20）, or cystic（5）. Calcification was seen in 14; pancreatic duct dilatation was present in 12 accompanied by bile duct dilatation in 3. The solid portions were hypo- or isodense with less contrast enhancement than the normal pancreatic tissue in the arterial phase and continuous enhancement in the venous and delayed phases. The cystic portions were hypodense without enhancement. The tumors were completely（30） or incompletely（4） encapsulated. 2 SPTP were complicated with peritoneal and liver metastases, and 3showed malignant transformation. Preoperative diagnosis was correct in 28 and erroneous in 6. Conclusion SPTP is seen most frequently in young women and may undergo malignant transformation with peritoneal and liver metastasis. MSCT features can aid diagnosis.

关 键 词：实性假乳头状瘤 胰腺肿瘤 体层摄影术 X线计算机 

分 类 号：R735.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]