胰腺腺鳞癌的多探测器计算机断层扫描表现  

Multi-detector computed tomograghy manifestations of pancreatic adenosquamous carcinoma of the pancreas

作　　者：杨来华 史涛涛[1] 祖大报 朱飞鹏[2] 孙志远[3] YANG Lai-hua;SHI Tao-tao;ZU Da-bao;ZHU Fei-peng;SUN Zhi-yuan(Department of Radiology,Danyang Hospital of Traditional Chinese Medicine,Danyang 212300,Jiangsu,China;Department of Radiology,Jiangsu Province People′s Hospital,Nanjing 210029,Jiangsu,China;Department of Radiology,General Hospital of Eastern Theater Command,Nanjing 210002,Jiangsu,China)

机构地区：[1]丹阳市中医院影像科,丹阳212300 [2]江苏省人民医院影像科,南京210029 [3]东部战区总医院(原南京军区南京总医院)影像科,南京210002

出　　处：《医学研究生学报》2022年第11期1180-1184,共5页Journal of Medical Postgraduates

基　　金：科技创新2030-重大项目“新一代人工智能”专项(202UAAA0109500)。

摘　　要：目的目前关于胰腺腺鳞癌(PASC)的影像学特征认识不足。文中旨在总结PASC的多探测器计算机断层扫描(MDCT)影像学表现并归纳其影像学特征,以提高对本病MDCT影像学表现的认识。方法回顾性分析2012年1月至2021年12月丹阳市中医院、东部战区总医院及江苏省人民医院经手术病理证实的21例行MDCT平扫及增强扫描的PASC患者的临床和影像学资料。分析肿瘤的MDCT表现及PASC的大体形态及病理特征。结果21例患者PASC均为单发病灶,其主要影像学表现:①主要为内生性生长;②体积较大,平均(38.92±18.44)mm,呈类圆形或椭圆形;③与正常胰腺相比,平扫肿瘤实性成分呈等/稍低密度、坏死/囊变呈低密度,增强扫描胰腺期均表现为低密度影,实性成分呈渐进性强化;④患者(85.71%)肿瘤边缘可见完整或不完整的强化环;⑤囊变或坏死多见;⑥胰管或胆管扩张及胰周血管包绕多见;⑦瘤内钙化较少,所有肿瘤内均未见出血。结论增强扫描PASC边缘环形强化、实性成分渐进性强化及局灶性坏死具有一定的特征性,熟悉PASC的MDCT影像学特征(内生性生长、体积较大、渐进性强化、局灶性坏死及完整或不完整强化环等),对其术前影像诊断具有重要意义。Objective To summarize the MDCT manifestaions of pancreatic adenosquamous carcinoma,analyze thier features and propose some diagnostic ideas in order to know more about its MDCT signs.Methods The plain and enhanced CT findings of 21 patients with pancreatic adenosquamous carcinoma proved pathologically were analyzed retrospectively in Danyang Hospital of Traditional Chinese Medicine,General Hospital of Eastern Theater Command,PLA and Jiangsu Province People's Hopital.The measurement data are expressed by mean±standard deviation(SD).Results All tumors were solitary,the main image findings were as follows:①the pancreas grew with endophyte;②they tended to be large,and the average diameter was(38.92±18.44)mm,with round or oval shape;③the lesions showed isodense/slight hypodense on plain scan and hypodense on enhanced scan and the solid areas showed slight enhancement in the pancreatic phase andcompared with normal pancreas;④most tumors had uniform or partial enhanced ring;⑤most lesions demonstrated cystic or necrotic;⑥pancreatic/biliary ductal dilatation and peripancreatic invasion were common;⑦few showed internal calcification or intratumoral hemorrhage.Conclusion Enhanced ring,focal cystic change or necrosis and progressive enhancing are features of pancreatic adenosquamous carcinoma,and to be famliar with theses MDCT features of pancreatic adenosquamous carcinoma are of great significance for the inpreoperative imaging diagnosis of pancreatic adenosquamous carcinoma.

关 键 词：胰腺肿瘤 胰腺腺鳞癌 多探测器计算机断层扫描 影像学 

分 类 号：R735.9[医药卫生—肿瘤]