胰腺实性假乳头状瘤超声造影及增强CT特征的对比研究  

Imaging findings of contrast-enhanced ultrasound in diagnosis of solid pseudopapillary tumor of pancreas compared with contrast-enhanced computed tomography

作　　者：杨泽邦 武文馨 张晓儿 黄通毅 蒋琳 姚佳倩 谢晓燕[1] 徐明[1] Yang Zebang;Wu Wenrin;Zhang Xiaoer;Huang Tongyi;Jiang Lin;Yao Jiaqian;Xie Xiaoyan;Xu Ming(Department of Medical Ultrasonics,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院超声医学科,广州510080

出　　处：《中华超声影像学杂志》2025年第3期216-224,共9页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金会(82402297)。

摘　　要：目的:探讨超声造影对胰腺实性假乳头状瘤的诊断价值,总结胰腺实性假乳头状瘤超声造影征象,并将其超声造影增强模式与增强CT比较。方法:回顾性收集中山大学附属第一医院2009年1月至2023年8月确诊为胰腺实性假乳头状瘤的70例患者的病例资料,包括基线资料、超声影像资料、增强CT资料,分析其图像特征并计算诊断准确率,采用独立样本Student t检验及Point-Biserial相关性分析显示超声征象与病变大小的关系,采用Mann-Whitney U检验比较准确率的差异。结果:超声造影下,胰腺实性假乳头状瘤在增强早期多见等增强(55.7%,39/70),在增强晚期多见低增强(74.3%,52/70),最常见的增强模式为等增强-低增强(41.4%,29/70);表现出3种典型造影征象:包膜强化(47.1%,33/70)、肿瘤内分隔强化(28.6%,20/70)、肿瘤内血管(25.7%,18/70),且三种征象的显示与较大的病变存在相关性(均P<0.001)。增强CT上的增强表现与超声造影差异有统计学意义(P=0.009),常见低增强-低增强(41.4%,24/58)和等增强-等增强(29.3%,17/58),且常出现渐进性强化。超声造影和增强CT诊断胰腺实性假乳头状瘤的准确率分别为71.4%和74.1%,两者诊断能力相当(P=0.733)。结论:超声造影在胰腺实性假乳头状瘤的诊断中具有较高的应用价值,其与增强CT的准确率相当。Objective:To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)in solid pseudopapillary tumor of pancreas(SPTP),summarize the CEUS characteristics of SPTP,and to compare its CEUS enhancement with contrast-enhanced computed tomography(CECT).Methods:In this retrospective study,baseline characteristics,basic ultrasound and CEUS images,CECT images of 70 patients diagnosed as SPTP from January 2009 to August 2023 were collected.Images were analyzed for extraction of key features and diagnostic accuracies of both CEUS and CECT were calculated.The relationships between ultrasound features and lesion size of SPTP were analyzed by Point-Biserial correlation analysis and Student t test.The diagnostic accuracy was compared by Mann-Whitney U test.Results:Iso-enhancement(55.7%,39/70)was commonly appeared in the early phase of CEUS for SPTP,while hypo-enhancement(74.3%,52/70)was the most common in the late phase.And the most common enhancement pattern was iso-hypo enhancement(41.4%,29/70).Lesion membrane enhancement(47.1%,33/70),intralesional compartmentalization(28.6%,20/70),and intralesional vessels(25.7%,18/70)were the 3 typical signs found in CEUS for SPTP,which were correlated with lesion size(P<0.001).Differences were found between the enhancement pattern of SPTP in CEUS and CECT,in which the most common enhancement patterns were hypo-hypo enhancement(41.4%,24/58)and iso-iso enhancement(29.3%,17/58)along with progressive enhancement.The diagnostic accuracies of CEUS and CECT were 71.4%and 74.1%respectively without statistically significant difference(P=0.733).Conclusions:CEUS shows high application value in the diagnosis of SPTP,and the accuracy of CEUS is comparable to that of CECT.

关 键 词：超声造影 胰腺实性假乳头状瘤 增强CT 增强模式 

分 类 号：R735.9[医药卫生—肿瘤]