胰腺实性-假乳头状瘤CT和磁共振诊断及鉴别诊断  

CT and MRI diagnosis and differential diagnosis of solid-pseudopapillary tumors of pancreas

作　　者：宋瑞娟[1] 关长旭[1] 张芳[1] 张凤翔[1] 

机构地区：[1]内蒙古自治区鄂尔多斯市中心医院CT-MRI室,017000

出　　处：《实用医学影像杂志》2018年第1期26-28,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨胰腺实性-假乳头状瘤的CT及磁共振(MR)表现,提高该疾病的影像正确诊断率。方法回顾分析14例经本院手术病理证实的胰腺实性-假乳头状瘤的影像学表现,14例均行CT和MRI检查。结果本组14例病例均为单发病灶,其中胰头颈部7例,胰体部4例,胰尾部3例,肿瘤最大径12.8 cm,最小径3.5cm,平均径5.6±0.8 cm。根据肿瘤所含成分不同,分成3种类型:实性(囊性成分体积≤10%)2例,囊实性9例,囊性(实性成分体积≤10%)3例。14例患者在CT检查中,2例可见钙化灶,其中断线样钙化1例,蛋壳样钙化1例;14例患者在MR检查中,2例在T1WI上出现高信号,提示肿瘤内部有出血;2例肿瘤边缘钙化在T1WI、T2WI呈断线样、弧形低信号。病理学诊断:12例为良性,1例为低度恶性,1例发生肝脏转移。所有病例随访1.5年以上,随访14例病例中,除去术前已发生肝转移的1例病情进一步恶化,余13例均未见复发或转移。结论胰腺实性-假乳头状瘤的影像学表现具有一定的特征性,结合临床资料,能做出诊断与鉴别诊断,为临床治疗方案提供准确信息。Objective To investigate the CT and MR findings of pancreatic solid - pseudopapillary tumor, and to improve the cmTect diagnosis rate of＂ the disease. Methods The imaging findings of 14 cases with solid papilloma of the pancreas confirmed by the operation and pathology were reviewed. CT and MRI were performed in 14 cases. Results The group of 14 cases were single lesions, including pancreatic head and neck in 7 cases, 4 cases of pancre- atic body, pancreatic tail in 3 cases, the largest diameter of 12.8 cm, the smallest diameter of 3.5 cm, the average di- ameter of 5.6 cm. According to the different components contained in the tumor, Tumors were divided into three types： solid （cystic component volume ~〈 10%） 2 cases, cystic solid 9 cases, cystic （solid content volume ~〈 10%） 3 cases. Forteen cases of patients in the CT examination, 2 cases of calcification can be seen, of which 1 case with broken line calcification, egg shell calcification in 1 case; 14 patients in the MR examination, 2 cases with high signal on the TtWI, suggesting that the tumor bleeding; 2 cases with marginal calcification in the TjWI, T2W1 was broken like, low-arc sig- nal,. Pathological diagnosis： ~2 cases with benign, 1＇ case wi^h low grade, 1 case wi^h li＇~er metastasis. All cases were followed up for more than 1.5 years. Of 14 cases with fi）llow-up, removal of preoperative liver metastases occurred in 1 case with further deterioration, the remaining 13 cases had no recurrence or metastasis. Conclusion Pancreatic solid- pseudopapillary tumor imaging performance has a certain characteristics, combined with clinical data, which can make a diagnosis and differential diagnosis, and provide accurate infiu＇mation for the clinical treatment program.

关 键 词：胰腺肿瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.44[医药卫生—诊断学] R735.9[医药卫生—临床医学]