胰腺实性假乳头状瘤的CT和MRI表现  

CT and MRI Appearances of Soild-Pseudopapillary Neoplasm of Pancreas

作　　者：谢欢[1,2] 印隆林[2] 苟文枭 陈晓煜[2] 王富民[2] 

机构地区：[1]西南医科大学,四川泸州646000 [2]四川省医学科学院、四川省人民医院放射科,四川成都610072

出　　处：《中国普外基础与临床杂志》2016年第4期493-498,共6页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨胰腺实性假乳头状瘤的CT和MRI表现,加深对SPNP的影像及临床病理特点认识,提高影像诊断水平。方法回顾性分析四川省医学科学院四川省人民医院2010年1月至2015年12月期间经手术和病理学检查证实的7例胰腺实性假乳头状瘤的临床及影像资料。重点分析肿块的大小、位置、生长方式、形态、包膜、钙化、出血以及与正常胰腺及周围组织的关系,胆管、胰管扩张等情况,在CT及MR平扫及增强扫描的图像特点。结果 7例均为女性。平均年龄28.3岁,肿瘤平均直径为5.7 cm。1例肿瘤位于胰头部、1例位于胰尾部,5例位于胰体尾部。外生性肿瘤5例,内生性肿瘤2例。肿瘤边界规则5例,不规则2例。4例行CT平扫加增强扫描,均表现为囊实混合型肿块,平扫呈等或低密度,增强扫描动脉期实性部分及囊壁有轻度强化,门静脉期及延迟期呈持续强化且强化程度增加,但始终低于正常胰腺实质;囊性部分三期均未见强化。另3例行MRI平扫加增强,2例肿块内可见出血,其中1例位于胰腺头部,包膜不完整,与十二指肠粘连,压迫胆总管导致肝内外胆管及胰管扩张、胆囊增大。结论胰腺实性假乳头状瘤的CT和MRI影像学表现有一定特征,通过影像学及临床特点可在术前做出较为准确的诊断。Objective To investigate the CT and MR imaging manifestation of solid-pseudopapillary neoplasm of pancreas（SPNP）, deepen the understanding of imaging and clinical pathological characteristics of SPNP and improve the level of diagnosis. Methods Between Jan 2010 and Dec 2015, the CT and MR imaging data of seven patients with SPTP proved by surgery and histopathologically were analyzed retrospectively. The following imaging features were reviewed： tumor size, location, shape, margin, encapsulation, calcification, hemorrhage, solid-cystic ratio, pancreatic and bile duct dilatation, the manifestation of plain scan and dynamic pattern of enhancement. Results The population comprised 7 women, the average age was 28.3 years old with a median tumor size of 5.7 cm. Tumors were located at body tail of pancreas in 5 cases, at the head in 1 case,and at the tail in 1 case. The tumor were exogenous in 5 cases, endogenous in 2 cases. Five tumors showed the regular margin, inregular in 2 cases. Four cases of plain and enhanced CT scan showed cystic-solid tumors,the solid and encapsulation part of SPNP presented as hipo-, iso-density, and gradually enhancement after injecting contrast medium. Three cases were examined by MRI, 2 cases appeared hemorrhage, tumor located in the head of pancreas leaded to the secondary ducts dilatations in 1 case. Conclusions There are some characteristics in CT and MRI manifestation of SPNP. Accurate diagnosis meybe created by the imaging study combined with the clinical feature.

关 键 词：胰腺实性假乳头状瘤 计算机体层成像 核磁共振成像 

分 类 号：R735.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2