侵袭性与非侵袭性胰腺实性假乳头状瘤CT影像特征分析  

Analysis of CT imaging features of invasive and noninvasive solid pseudopapillary tumors of the pancreas

作　　者：刘帅博 张宁[1] 朱绍成[2] LIU Shuaibo;ZHANG Ning;ZHU Shaocheng(Department of Medical Imaging,Henan Provincial People's Hospital of Xinxiang Medical University,Xinxiang 453003,Henan,China;Department of Medical Imaging,Henan Provincial People's Hospital,Zhengzhou 450003,Henan,China)

机构地区：[1]新乡医学院河南省人民医院医学影像科,新乡453003 [2]河南省人民医院医学影像科,郑州450003

出　　处：《医学研究与战创伤救治》2024年第10期1040-1044,共5页Journal of Medical Research & Combat Trauma Care

基　　金：河南省重点研发与推广专项(科技攻关)(212102310729);郑州市协同创新重大专项(20XTZX11020);北京康盟慈善基金会医学科研发展基金项目伦琴影像科研专项(HN-20201017-003)。

摘　　要：目的探讨侵袭性与非侵袭性胰腺实性假乳头状瘤(SPTP)的CT影像特征。方法回顾性分析河南省人民医院2017年2月至2023年9月经病理证实的91例患者临床及CT影像资料,根据病理结果分为侵袭性组(n=23)、非侵袭性组(n=68)。分析两组性别,肿瘤位置,包膜,有无钙化及胰管扩张,囊实性指标及肿瘤长径、肿瘤及正常肝组织平扫、动静脉期密度等指标之间的差异。采用受试者操作特征(ROC)曲线、Logistic回归分析及Delong检验评价单独或联合应用肿瘤长径、肿瘤静脉相对增强、肿瘤肝脏静脉比指标对两组肿瘤鉴别的价值。结果侵袭性组与非侵袭性组肿瘤包膜、胰管扩张、囊实性的差异具有统计学意义(P<0.05);两组肿瘤长径、肿瘤静脉相对增强、肿瘤肝脏静脉比差异有统计学意义(P<0.05)。肿瘤长径、肿瘤静脉相对增强、肿瘤肝静脉比单独或联合指标对两组肿瘤的鉴别效能较好(P<0.05),两两对比后,各项指标对两组肿瘤的鉴别效能差异并无统计学意义(P>0.05)。结论与非侵袭性SPTP相比,侵袭性SPTP多以实性成分为主,多无包膜或包膜不完整,胰管扩张多见,病灶长径更小,静脉期相对强化程度更高,为指导临床决策提供了有力依据。Objective The study is to investigate the CT imaging features of invasive and noninvasive solid pseudopapillary tumors of the pancreas.Methods The clinical data and CT data of 91 patients with pseudopapillary tumors of the pancreas,who were pathologically confirmed in Henan Provincial People's Hospital,from February 2017 to September 2023,were retrospectively analyzed.According to the pathological results,they were divided into an invasive group(n=23)and a non-invasive group(n=68).The differences in gender,tumor location,capsule,calcification and pancreatic duct dilatation,cystic-solid index,tumor long diameter,tumor and normal liver tissue plain scan,arteriovenous phase density,etc.were analyzed between the two groups.(ROC)curve,Logistic regression analysis and Delong test were used to evaluate the value of single or combined use of tumor long diameter,tumor vein relative enhancement,and tumor-liver vein ratio in differentiating tumors between the two groups.Results There were significant differences in tumor capsule,pancreatic duct dilatation,and cystic solidity between the invasive group and the non-invasive group(P<0.05);there were significant differences in tumor long diameter,tumor vein relative enhancement,and tumor-hepatic vein ratio(P<0.05).The long diameter of tumor,relative enhancement of tumor vein,and tumor-to-hepatic vein ratio alone or in combination had good discriminatory efficacy for the two groups of tumors(P<0.05).After pairwise comparison,there was no statistically significant difference in the discriminatory efficacy of each index for the two groups of tumors(P>0.05).Conclusion Compared with noninvasive SPTP,tumors in invasive SPTP is mainly composed of solid components,without capsule or incomplete capsule,pancreatic duct dilation is common,the long diameter of the lesion is smaller,and the relative enhancement degree in the venous phase is higher,which provides a strong basis for guiding clinical decision-making.

关 键 词：胰腺肿瘤 体层摄影术 X线计算机 

分 类 号：R735.9[医药卫生—肿瘤]