胰腺腺泡细胞癌的增强MRI和DWI特征  

Magnetic resonance imaging features of pancreatic acinar cell carcinoma

作　　者：董浩 王明亮 纪元 曾蒙苏 DONG Hao;WANG Mingliang;JI Yuan;ZENG Mengsu(Department of Radiology,First People's Hospital,Xiaoshan District,Hangzhou 311200,China;Department of Radiology,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China;Department of Pathology,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China)

机构地区：[1]浙江省杭州市萧山区第一人民医院放射科,浙江杭州311200 [2]复旦大学附属中山医院放射科,上海200032 [3]复旦大学附属中山医院病理科,上海200032

出　　处：《医学影像学杂志》2023年第12期2232-2235,共4页Journal of Medical Imaging

摘　　要：目的探讨胰腺腺泡细胞癌(PACC)的增强MRI和DWI特征。方法选取并分析经病理证实的14例PACC患者的病例资料,分析患者的肿瘤位置、形状、大小、边界、有无囊变坏死、囊实性交界面是否清晰、有无出血、胰管有无扩张、MRI信号特点及强化方式、有无转移、有无周围组织受累及淋巴结肿大等情况,测量肿瘤实质及其周围正常胰腺组织的ADC值,并进行统计学分析。结果14例患者肿瘤均为单发,肿瘤范围1.9~14.0cm,最大径(5.1±3.0)cm,7例位于胰头部,7例位于胰体尾部,11例呈类圆形,10例病灶边缘清晰,8例出现不同程度囊变坏死,囊变坏死范围5例<30.0%,2例30.0%~70.0%,1例>70.0%,2例出血,8例出现胰管扩张与胰腺萎缩,肿瘤实质13例T_(1)WI呈低或稍低信号,10例T_(2)WI呈稍高或高信号,14例DWI均呈高信号,ADC图均呈低信号,12例呈轻度渐进性强化,2例呈轻中度持续强化,各期强化程度均低于正常胰腺组织,9例出现周围组织受累,7例发生肝脏和(或)淋巴结转移,肿瘤实质的平均ADC值为(1.033±0.247)×10^(-3)mm^(2)/s,周围正常胰腺组织的平均ADC值为(1.807±0.434)×10^(-3)mm^(2)/s,两者差异有统计学意义(t=-7.518,P<0.001)。结论PACC在MRI具有一定的特征性。Objective To explore the MR imaging characteristics of pancreatic acinar cell carcinoma(PACC).Methods We retrospectively analyzed the data of 14 PACC patients who were pathologically confirmed in Zhongshan Hospital of Fudan University,and analyzed the tumor location,shape,size,boundary,presence or absence of cystic necrosis,and cystic solid,whether the sexual intercourse interface was clear,whether there was bleeding,whether the pancreatic duct was dilated,the characteristics of MRI signal and the way of enhancement,whether there was metastasis,whether the surrounding tissues were involved,and the lymph nodes are enlarged,etc..We measured the appearance of the tumor parenchyma and the surrounding normal pancreatic tissue apparent diffusion coefficient(ADC)value,and carried out statistical analysis.Results The tumors in 14 patients were all single,the largest tumor diameter was(5.1±3.0)cm,and the range was 1.9-14.0 cm.Seven cases were located in the head of the pancreas,7 cases were located in the body and tail of the pancreas,11 cases were round,and 10 cases had lesions.The margins were clear,8 cases had different degrees of cystic degeneration and necrosis,2 cases had hemor-rhage,8 cases had pancreatic duct dilatation and pancreatic atrophy,13 cases of tumor parenchyma showed low or slightly low signal on T_(1)WI,10 cases showed slightly high or high signal on T_(2)WI,14 cases showed DWI showed high signal,ADC map showed low signal,12 cases showed mild progressive enhancement,2 cases showed mild to moderate continuous enhancement,the enhancement degree at each stage was lower than normal pancreatic tissue,9 cases showed surrounding tissue involvement,7 cases showed the average ADC value of tumor parenchyma was(1.033±0.247)×10^(-3)mm^(2)/s,and the average ADC value of sur-rounding normal pancreatic tissue was(1.807±0.434)×10^(-3)mm^(2)/s,the difference was statistically significant(t=-7.518,P<0.001).Conclusion Pancreatic acinar cell carcinoma has certain characteristics on MR images.

关 键 词：胰腺肿瘤 腺泡细胞癌 磁共振成像 

分 类 号：R736.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]