胰腺少见肿瘤的MRI表现及文献复习  

MRI features of rare pancreatic neoplasms and literature review

作　　者：王斌[1] 唐康 郝金钢[1] WANG Bin;TANG Kang;HAO Jingang(Department of Radiology,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院放射科,云南昆明650101

出　　处：《实用放射学杂志》2023年第2期233-236,共4页Journal of Practical Radiology

摘　　要：目的探讨胰腺少见肿瘤的MRI影像特征。方法对14例经手术病理证实为胰腺少见肿瘤患者的MRI检查资料进行回顾性分析。结果腺鳞癌(ASqC)4例,T_(1)WI呈低信号,T2WI呈不均匀稍高信号,可见中央坏死,动态增强扫描渐进性边缘强化。淋巴瘤4例,T_(1)WI呈稍低信号,T_(2)WI呈稍高信号,扩散加权成像(DWI)肿瘤实性成分呈高信号,动态增强扫描呈轻中度强化。孤立性纤维性肿瘤(SFT)1例,T1WI呈低信号,T_(2)WI呈不均匀稍高信号,动态增强扫描“快进慢出”。肝样腺癌(HAC)1例,T_(1)WI呈低信号,T_(2)WI呈混杂稍高信号,动态增强扫描“快进快出”。转移瘤2例,T_(1)WI呈低信号,T2WI呈不均匀稍高信号,动态增强扫描的强化模式与原发肿瘤一致。黏液性囊性肿瘤伴相关浸润性癌(MCN-AIC)2例,表现为胰腺内多发囊状长T_(1)长T_(2)信号影,可见壁结节及软组织影,动态增强扫描囊壁、分隔及壁结节渐进性强化。结论胰腺少见肿瘤大多边界清楚,MRI动态增强扫描具有一定特征性:ASqC呈伴中央坏死的渐进性强化;淋巴瘤呈伴“血管漂浮征”的轻中度强化;SFT呈“快进慢出”样强化;HAC呈伴有坏死的“快进快出”样强化;转移瘤强化模式多样,多与原发肿瘤一致;MCN-AIC分隔与壁结节呈渐进性强化。Objective To investigate the MRI imaging features of rare pancreatic neoplasms.Methods The MRI data in 14 patients with rare pancreatic neoplasms confirmed by operation and pathology were analyzed retrospectively.Results Adenosquamous carcinoma(ASqC)in 4 cases appeared as hypointensity on T1WI and heterogeneously slight hyperintensity on T2WI,with necrosis in the center of the lesions and progressively marginal enhancement on the dynamic contrast enhancement MRI.Lymphoma in 4 cases appeared as slight hypointensity on T1WI and slight hyperintensity on T2WI.And the solid part of the tumor represented high signal on diffusion weighted imaging(DWI)and mild-to-moderate enhancement on dynamic contrast enhancement MRI.Solitary fibrous tumor(SFT)in 1 case appeared as hypointensity on T1WI,heterogeneously slight hyperintensity on T2WI,and“fast wash-in and slow wash-out”of dynamic contrast enhancement MRI.Hepatoid adenocarcinoma(HAC)in 1 case appeared as hypointensity on T1WI,mixed slight hyperintensity on T2WI,and“fast wash-in and fast wash-out”of dynamic contrast enhancement MRI.Metastasis in 2 cases appeared as hypointensity on T1WI,mixed slight hyperintensity on T2WI,and the same dynamic contrast enhancement patterns as the primary tumors.Mucinous cystic neoplasm with associated invasive carcinoma(MCN-AIC)in 2 cases appeared as multiple cystic lesions with long T1 and long T2 signal with wall nodules and soft tissue.Dynamic contrast enhancement MRI showed a progressive enhancement of the cystic wall,septum,and wall nodules.Conclusion Most rare pancreatic neoplasms have clear boundaries and certain characteristics on dynamic contrast enhancement MRI:progressive enhancement with central necrosis in ASqC,mild-to-moderate enhancement with“vessel floating sign”in lymphoma,“fast wash-in and slow wash-out”mode in SFT,“fast wash-in and fast wash-out”mode with necrosis in HAC,the same enhancement modes as the primary tumors in most metastasis,and progressive enhancement of the septum and wall nodules in MCN-

关 键 词：胰腺 少见肿瘤 磁共振成像 

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