胰腺少见肿瘤的CT及MRI诊断(附34例报道)  

CT and MRI diagnosis of rare pancreatic tumors

作　　者：谢欢 印隆林[1,2] 苟文枭 陈晓煜[2] 王富民[2] 

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

出　　处：《中国普外基础与临床杂志》2017年第1期107-114,共8页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨胰腺少见肿瘤的CT和MRI表现,以期加深对这类肿瘤影像学特征的认识并提高诊断准确性。方法回顾性分析34例经手术及病理学检查证实的胰腺少见肿瘤的临床及影像资料,包括神经内分泌肿瘤(neuroendocrine tumor of the pancreas,NETP)13例、实性假乳头状瘤(solid-pseudopapillary tumor of pancreas,SPTP)10例、导管内乳头状黏液瘤(intraductal papillary mucinous neoplasm,IPMN)2例、浆液性囊腺瘤(serous cystadenoma,SCA)7例和黏液性囊腺瘤(mucinous cystadenoma,MCA)2例。行CT检查19例,行MRI检查11例,同时行CT和MRI检查者4例。重点分析每种肿瘤的特征性影像学表现。结果 13例NETP中,实性肿块6例、实性成分为主4例、囊性成分为主3例;增强扫描较均匀强化6例、不均匀强化7例;肿瘤实性成分均呈中到明显强化。10例SPTP中,实性成分为主2例,囊实性成分相仿5例,囊性成分为主3例;10例肿瘤实性成分均呈渐进性强化,3例肿瘤有出血、1例见斑点状钙化。2例IPMN均为混合型,表现为胰管扩张形成的多房囊性肿瘤。7例SCA中,微囊型3例、单囊型4例;表现为边界清楚的单囊或多囊性肿瘤。2例MCA均表现为边界清楚的单囊性肿瘤。结论不同组织学类型的胰腺少见肿瘤各具其特征性的影像学表现,通过分析这些特点可以提高这类肿瘤的诊断准确性。Objective To investigate the CT and MR imaging manifestation of rare pancreatic tumors in order to deepen the understanding of their imaging characteristics and improve the diagnostic accuracy. Methods Clinical and image date of 34 cases with rare pancreatic tumors proved by surgery and histopathologically were analyzed retrospectively. Including neuroendocrine tumors of the pancreas （NETP,n=13）, solid-pseudopapillary tumors of pancreas （SPTP,n=10）, intraductal papillary mucinous neoplasms （IPMN,n=2）, serous cystadenoma （SCA,n=7）, and mucinous cystadenoma （MCA,n=2）. Examined by CT in 19 cases, by MRI in 11 cases, examined by CT and MRI at the same time in 4 cases. The characterized imaging features of each kind of tumors were analyzed emphatically. Results Of the 13 cases of NETP, solid lesions in 6 cases, predominantly soild in 4 cases, predominantly cystic in 3 cases. Homogenous enhancement in 6 cases, heterogeneous enhancement in 7cases, the soild constituent of all cases were showed moderate to marked enhancement. Of the 10 cases of SPTP, predominantly soild in 2 cases, soild and cystic in 5 cases, predominantly cystic in 3 cases. The solid part of 10 cases presented as gradually enhancement, 2 cases appeared hemorrhage, 1 case appeared stippled calcification. Of the 2 cases of IPMN, both of them were combined type, showed multilocular cystic tumors due to the dilated of the pancreatic duct. Of the 7 cases of SCA, microcystic partten in 3 cases and single cyst partten in 4 cases, showed unilocular or multilocular cystic with clear boundary. The 2 cases of MCA, showed unilocular cystic with clear boundary. Conclusion Different histological types of pancreatic rare tumor appeared different kinds of imaging characteristic, we may improve the diagnostic accuracy by analyzing their features.

关 键 词：胰腺肿瘤 诊断 计算机体层成像 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