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胰腺实性假乳头状 瘤的CT和MRI征象及病理回顾

作者:周 洁1 曾旭文1 梁治平1 陈 淮2 陈 松1 钟敏之1

所属单位:1.暨南大学医学院第四附属医院 (广州市红十字会医院)放射科 (广东 广州 510220) 2.广州医科大学附属第一医院放射 科 (广东 广州 510120)

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摘要

目的 探讨胰腺实性假乳头状瘤 (SPTP)的CT和MRI征象,提高对该病影像 征象的认识。方法 回顾性分析2008年至 2014年间于我院经手术后病理确诊为胰 腺实性假乳头状瘤的15例患者的CT及MRI 图像,并与病理结果对照。结果 肿瘤以 囊性成分为主型5例,实性成分为主型3 例,囊实性比例相间型7例。其中2例病灶 可见出血,3例病灶可见钙化。CT平扫肿 瘤实性部分CT值平均(37.56±9.53)Hu; 增强动脉期平均(54.5±9.75)Hu;门脉期 平均(72.0±17.1)Hu,呈渐进性强化。囊 性部分平扫平均(24±12.52)Hu;增强扫 描无强化。MRI上肿瘤实性成分T1WI呈等/ 稍低信号,T2WI呈等/稍高信号,增强扫 描呈延迟强化趋势。囊性成分T1WI呈低信 号,T2WI呈高信号,增强扫描无强化。肿 瘤包膜在T1WI及T2WI上均呈低信号,增强 扫描呈延迟强化。2例肿瘤内出血病灶在 T1WI上可见环样、云絮样高信号,相应区 域在T2WI上呈低信号。3例肿瘤内钙化在 T1WI及T2WI上均呈低信号。结论 胰腺实 性假乳头状瘤的CT、MRI征象有一定的特 征性,术前如能抓住该病的特征性影像表 现,对其定性诊断有很大的帮助。

Objective To explore the imaging characterize and to analysis the pathology organization of solid pseudopapillary tumors of pancreas. Methods Retrospective analysis of 15 cases diagnosed as solid pseudopapillary tumors of pancreas by pathology after surgery in patients with CT and MRI images. Results Tumors contained mostly cystic component in 5 cases and mostly solid components in 3cases,contained similar proportion of solid and cystic part in 7 cases.Tumor hemorrhage in 2 cases and tumor with calcification in 3 cases. CT scan solid part of the tumor CT value of the average is (37.56±9.53)Hu, enhanced arterial phase average (54.5±9.75)Hu, venous phase average (72.0±17.1)Hu,showed a gradual strengthening. CT scan Cystic part of the tumor CT value of the average is (24±12.52)Hu,enhanced scan without enhancement.Solid tumor components T1WI showed equal/lower signal, T2WI showed equal/higher signal, enhanced scan showed a trend of delayed enhancement. Cystic component T1WI showed low signal, T2WI showed high signal, enhanced scan without enhancement. Tumor capsule showed low signal on T1WI and T2WI, enhanced scan showed delayed enhancement. 2 cases of tumor hemorrhage lesions on T1WI visible ring-like, cloud-like high signal, Corresponding area on T2WI showed low signal.2 cases of Calcification within the tumor showed low signal on T1WI and T2WI. Conclusion There are certain characteristics of the The imaging features of solid pseudopapillary tumors of pancreas. There would be a great help to their diagnosis if they can catch the disease characteristic imaging findings preoperatively.

【关键词】实性假乳头状瘤;胰腺;体层摄影术

【中图分类号】R322.4+91

【文献标识码】A

【DOI】10.3969/j.issn.1672- 5131.2016.08.001

前言

胰腺实性假乳头状瘤是一种少见的胰腺肿瘤,通常为良性或低度 恶性。临床症状不典型,或因腹胀、腹痛发现肿块,影像学上对其报 道也比较少,误诊情况比较多。现就本院经手术后病理确诊为胰腺实 性假乳头状瘤的15例完整影像学资料及病理结果进行分析,探讨其影 像学特征性表现及对其病理组织进行分析。