胰岛细胞瘤与胰岛细胞增生症的MRI诊断(附7例报告)  

The MRI Diagnosis of islet cell tumor and islet cell hyperplasa

作　　者：包强[1] 王尔祯[1] 林梅[1] 林孟光[1] 严刚[1] 

机构地区：[1]福建省立医院MR室,350001

出　　处：《福建医药杂志》2002年第6期5-6,共2页Fujian Medical Journal

摘　　要：目的　探讨胰岛细胞瘤与胰岛细胞增生症平扫与增强的影像特点。方法　分析经手术与病理证实的胰岛细胞瘤 6例 (其中多发性 3例 )、胰岛细胞增生症 1例的 MRI影像特点 ,并与 B超对比。按功能分类 :本组中胰岛素瘤 5例 ,胰岛素细胞增生症 1例 ,胰高血糖素瘤 1例。扫描序列 :常规行 SE/ TSE:T1 WI、T2 WI,部分加行脂肪抑制的 T1 WI与 T2 WI,行 Gd- DTPA常规增强 T1 WI。结果　 (1)胰岛素瘤 :形态呈类圆形或卵圆形 ,最大径为 1.0～ 2 .5 cm ,常规 T1 WI呈略低信号 ,边界不清 4 / 5 ,其中 2例加行 fs- T1 WI后病灶边界变清 ;常规 T2 WI呈高信号 4 / 5 ,边界清(其中 1例行 fs- T2 WI病灶边界更清 ) ,呈等信号 1/ 5 ,边界不清 ;常规增强呈等信号 2 / 5 ,强化不明显呈略低信号 2 / 5 ,不均匀强化 1/ 5。 3例 (3/ 5 )各有两个瘤体 ,但术前 MRI均漏诊 1个病灶。 5例 8个病灶中 B超仅检出 1个病灶 ,呈低回声。 (2 )胰岛素细胞增生 :呈卵圆形结节状外突 ,最大径为 1.5 cm,呈等 T1 等 T2 信号 ,与胰腺分界不清 ,B超未检出病灶。 (3)胰高血糖素瘤 :呈卵圆形 ,最大径为 8cm,呈混杂信号 ,以长 T1 长 T2 信号为主 ,间有斑状短 T1 略短T2 信号 ,常规增强呈稍不均匀强化 ,在 T1 WI与 T2 WI上有完整的线状低信号包膜。B超呈?Objective To study the MRI characteristics of islet cell tumor and islet cell hyperplasia with non enhanced and enhanced scans.Methods Analysis was made on the MRI characteristics of 6 cases with islet cell tumor(among them 3 cases were multiple) and 1 case with islet cell hyperplasia.All of them were confirmed surgically and pathologically.The MRI results were compared with B US ones.Based on the function,this group included 5 cases with insuloma,1 case with islet cell hyperplasia,and 1 case with glucagonoma.With Impact 1 0T MR scanner,SE/TSE T 1WI and T 2WI were done routinely in all cases.In addition,fat suppressed(fs)T 1WI and T 2WI in 3 cases;routine enhanced T 1WI with GD DTPA in 6 cases.Results 1.Insuloma:Its MRI findings were as follows:(1)The lesions were round or oval in shape with 1 0～2 5cm as maximal diameters;(2)All the cases(n=5) showed slightly low signal on T 1WI;(3)The border was vague on T 1WI in 4 cases(4/5),among them 2 cases became clearer on fs T 1WI;(4)On T 2WI,high signal and clear border were seen in 4 cases (among them,the border became clearer on fs T 2WI in 1 case)and equal signal with vague border in 1 case;(5)On routine enhanced T 1WI,equal signal was seen in 2 cases,no obvious enhancement with slightly low signal in 2 cases and hetero enhancement in 1 case;(6)3 cases(3/5) had two lesions respectively,however,one lesion was missed in pre operational MRI in each case.Among them 2 cases were due to neglect after detection of the first lesion;another case was due to its equal signal,so it cant be found.Among 8 lesions in the 5 cases,only 1 lesion was detected by B US with weak echo.2.Islet cell hyperplasia:It appeared oval and nodular prominence in shape with maximal diameter 1 5cm,equal signal on T 1WI and T 2WI,and no clear border between the tumor and normal pancreas tissue.It was missed by B US.3.Glucagonoma of pancreas:It was oval in shape with maximal diameter 8cm.The majority were long T 1 and long T 2 signals,mixed with mottled short T 1 and

关 键 词：诊断 胰岛细胞瘤 胰岛细胞增生 磁共振成像 

分 类 号：R736.7[医药卫生—肿瘤]