儿童胰腺实性假乳头状瘤CT和MRI征象  

CT and MRI findings of solid pseudopapillary tumor of pancreas in children

作　　者：崔芷萌 任刚[1] 蔡嵘[2] 赵江 汪心韵 CUI Zhimeng;REN Gang;CAI Rong;ZHAO Jiang;WANG Xinyun(Department of Radiology,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Radiotherapy,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属新华医院放射科,上海200092 [2]上海交通大学医学院附属瑞金医院放疗科,上海200025

出　　处：《临床儿科杂志》2021年第5期332-337,共6页Journal of Clinical Pediatrics

摘　　要：目的探讨儿童胰腺实性假乳头状瘤(SPTP)的CT和MRI影像学征象。方法回顾分析经手术、病理证实的SPTP患儿的临床及影像资料。结果共纳入21例SPTP患儿,男2例、女19例;平均年龄(11.00±2.66)岁。19例行术前CT检查,7例行术前MRI检查。21例患儿均为单发病灶,肿瘤最大径中位数5.80(5.00~7.31)cm,多位于体尾部。病灶均为囊实性,其中实性为主9例,囊性为主2例,囊实性成分相当10例。计算机X线体层摄影术(CT)平扫常表现为界限清楚、等密度或稍低密度囊实性肿块。磁共振成像(MRI)平扫实性部分表现为T1WI低信号、T2WI高信号,可伴有T1WI高信号出血灶;动态增强扫描示实性部分动脉期轻度强化,门脉期渐进性强化,增强各期强化程度均低于正常胰腺实质。5例患儿为恶性SPTP,最大径均>5.00 cm,包膜均不完整,其中3例呈分叶状,2例伴钙化。结论SPTP的CT和MRI影像学表现具有一定特征,对术前正确诊断及评估肿瘤恶性风险具有重要价值。Objective To investigate the imaging signs of CT and MRI for pediatric solid pseudopapillary tumor(SPTP)of the pancreas.Methods This study retrospectively reviewed 21 cases of SPTP confirmed by clinic surgery and pathology.Results Among the 21 cases,there were two males and 19 females.The median age was 11 years.Preoperative CT scan was performed in 19 patients,and preoperative MRI scan was performed in 7 patients.All the 21 cases were of single lesion and often occurred in the body/tail of pancreas,with a mean diameter of 5.80(5.00~7.31)cm.All tumors were cystic and solid masses.Nine cases were mainly composed of solid tissue.The other two cases mainly had cystic components.Ten cases were composed of cystic and solid tissue,and the proportion of cystic components was close to solid components.On precontrast CT scan,SPTPs were typically well demarcated,and equal/low density lesions comprising both solid and cystic components.MRI showed that the solid components of the tumor showed low signal in T 1 WI and slightly higher signal in T 2 WI,hemorrhage was showed high signal in T 1 WI.The solid portion was mild to obviously enhanced slightly in the arterial phase,with an enhancement degree lower than normal pancreas,and progressive enhancement in the portal venous phase.In this group,five cases were confirmed to be malignant SPTP by surgery and pathology,with all the lengths greater than 5 cm and incomplete capsule,among which 3 cases were lobulated,and 2 cases had mass calcification.Conclusion The characteristic imaging signs of CT and MRI for pediatric solid SPTP have significant value in the diagnosis correctly and evaluation the malignant risk of tumor before surgery.

关 键 词：胰腺实性假乳头状瘤 计算机X线体层摄影术 磁共振成像 儿童 

分 类 号：R735.9[医药卫生—肿瘤]