胰腺浆液性囊腺瘤的影像学类型与病理对照  

Serous cystadenoma of the pancreas:a comparative study of imaging types and pathological features

作　　者：张宏艳[1] 王志锋 马小龙[3] 杨盼盼[3] 张雪凤[3] 袁渊[3] 王铁功[3] 

机构地区：[1]第二军医大学附属公利医院医学影像科,上海200135 [2]宁波中医院放射科,浙江315010 [3]第二军医大学附属长海医院影像医学科,上海200433

出　　处：《放射学实践》2015年第7期768-771,共4页Radiologic Practice

摘　　要：目的:探讨胰腺浆液性囊腺瘤(SCP)影像学类型与其病理基础的关系。方法:回顾性分析42例经病理证实的SCP的影像学和病理资料。所有患者均行CT和MRI平扫加增强检查。根据囊腔的数量、大小和排列形态将SCP分为多囊型、单囊型、蜂巢型和实型,并与病理结果相对照。结果:42例SCP中,多囊型19例,单囊型4例,蜂巢型16例,实型3例。中央瘢痕样结构较为常见(多囊型89%,实型67%和蜂巢型44%)。蜂巢型表现为难以计数的微小囊腔密集蜂巢状排列。实型在CT图像上表现为"实性肿瘤"的密度和强化方式,但在MR T2WI和MRCP图像上显示囊性肿瘤信号特征。89%的多囊型具有分叶状轮廓;6例钙化全部发生在中央瘢痕样结构内。仅有1例囊腔内有出血。所有囊壁均未见壁结节。病理显示所有病例镜下均为单层立方上皮细胞覆盖内壁的囊腔性结构,不同类型SCP囊腔的大小、数量和排列不同。结论:在SCP的影像学类型中,多囊型、蜂巢型和实型都具有影像学特征性表现,不同影像学类型表现与病理形态密切相关。Objective：To explore the correlation between imaging types of serous cystadenoma of the pancreas（SCP）and their elemental pathological features.Methods：The imaging and pathological data of 42 patients with SCP confirmed by pathology were analyzed retrospectively.All patients underwent CT and MR examinations with plain and enhancement scan.According to the quantity,diameter and arrangement pattern of tumor＇s capsules,all cases were divided into polycystic type,unilocular cystic type,honeycomb type and solid type which were compared with their pathological findings.Results：As for the 42 cases of SCP,there were 19 cases of polycystic type,4unilocular type,16 cellular type and 3solid type.A central scar-like tissue was the most commonly presented feature（seen on 89%in polycystic,67%in type,and 44%in honeycomb）.The capsules of cellular tumors were composed by tiny uncountable ones arranged similar to a honeycomb.The density and enhanced pattern of solid tumors had the similar characteristics of a regular solid tumor on CT,but appeared as a cystic signal feature on T2-weighted imaging and MRCP.Lobulated shape were seen in 89% polycystic.The occurrence of calcifications were found only in the scar-like tissue.Hemorrhage was showed in only one case within the cyst.Mural nodule was not seen in all cases.All tumors appeared as multiple capsules covered with a single layer of cuboidal epithelial cells under microscope.However,the diameter,quantity and arrangement pattern of the capsules were different in different types of SCP.Conclusion：Polycystic type,cellular type and solid type have their own imaging features,which are correlative with its different pathological features.

关 键 词：胰腺肿瘤 浆液性囊腺瘤 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] R445.2[医药卫生—临床医学] R730.44