胰腺内异位副脾影像学特点及误诊原因分析  

Analysis of Imaging Characteristics and Causes of Misdiagnosis of Ectopic Intrapancreatic Accessory Spleen

作　　者：郑雪 王新江[1] 关志伟[2] 王曙霞[3] 朱平[3] 姚洪祥[1] ZHENG Xue;WANG Xinjiang;GUAN Zhiwei;WANG Shuxia;ZHU Ping;YAO Hongxiang(Department of Radiology,the Second Medical Center of Chinese PLA General Hospital/National Clinical Research Center for Geriatric Diseases,Beijing 100853,China;Department of Nuclear Medicine,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Geriatrics,the Second Medical Center of Chinese PLA General Hospital/National Clinical Research Center for Geriatric Diseases,Beijing 100853,China)

机构地区：[1]国家老年疾病临床医学研究中心解放军总医院第二医学中心放射诊断科,北京100853 [2]解放军总医院第一医学中心核医学科,北京100853 [3]国家老年疾病临床医学研究中心解放军总医院第二医学中心老年医学科,北京100853

出　　处：《临床误诊误治》2025年第9期1-6,共6页Clinical Misdiagnosis & Mistherapy

基　　金：科技部国家重点研发计划(2020YFC2008900)。

摘　　要：目的 分析胰腺内副脾临床及影像学特点,探讨误诊原因及防范误诊措施。方法 回顾性分析2022年6至9月曾误诊的胰腺内异位副脾患者2例的临床及影像学资料。结果 2例均为体检CT平扫发现胰尾部占位性病变,MRI平扫和动态增强扫描表现为富血供占位,PET-CT检查病变呈高代谢,术前均诊断为神经内分泌肿瘤,行手术切除,术后病理检查为胰腺内异位副脾。误诊时间为53 d和46 d。2例均预后良好。结论 胰腺内异位副脾影像学表现不典型,易误诊为神经内分泌肿瘤,因此放射诊断科医生应加强本病影像学特点、诊断及鉴别诊断要点的学习,提高诊断正确率。Objective To analyze the clinical and imaging characteristics of ectopic intrapancreatic accessory spleen(IPAS),and to explore the causes and preventive measures of misdiagnosis.Methods The clinical and imaging data of 2 patients with ectopic IPAS misdiagnosed from June to September 2022 were retrospectively analyzed.Results In both patients,CT plain scan showed space occupying of pancreatic tail,MRI plain scan and dynamic enhancement showed space occupying with rich blood supply,and PET-CT showed high metabolism.Both cases were diagnosed as neuroendocrine tumor before surgery and underwent surgical resection.The postoperative pathology was ectopic IPAS.The misdiagnosis time lasted 53 d and 46 d respectively.Both patients had good prognosis.Conclusion The imaging findings of ectopic IPAS are atypical,and it is prone to misdiagnosis as neuroendocrine tumor.Therefore,the radiologists should strengthen the understanding of the imaging characteristics,diagnosis and differential diagnosis of this disease,and improve the diagnostic accuracy.

关 键 词：胰腺肿瘤 异位副脾 误诊 神经内分泌瘤 磁共振成像 正电子发射计算机断层显像 病理学 

分 类 号：R735.9[医药卫生—肿瘤]