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·腹部疾病·

胰腺实性假乳头状瘤的MSCT表现

作者:张广彬1 徐志锋2 张永辉1 葛小兵1

所属单位:1.广东省化州市人民医院放射科 (广东 化州 525100) 2.广东省佛山市第一人民医院CT室 (广东 佛山 528000)

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摘要

目的 探讨胰腺实性假乳头状瘤(SPTP)的CT表现特点,提高诊断水平。方法 回顾性分析经病理证实的9例SPTP的CT 表现,其中男1例,女8例;年龄10-52岁,平均年龄32岁,所有病例均行CT平扫及多期动态增强检查。结果 肿瘤 位于胰尾6例,胰头2例,胰体1例。8例呈类圆形,1例呈不规则分叶状,肿瘤最大径为4.7-12cm,平均为6.8cm。6 例SPTP呈囊实性,2例呈囊性,1例呈实性。4例SPTP的CT扫描见出血征象;6例可见钙化,5例边缘斑点、斑片状钙 化,1例呈环壁蛋壳状钙化。增强扫描动脉期肿瘤实性部分轻度强化,门静脉期呈明显强化,呈渐进性向心性强化 特点。结论 SPTP的CT表现具有一定特征,结合临床特点可以做出诊断。

Objective To study the MSCT findings of solid pseudopapillary tumors of the pancreas(SPTP), in order to improve the diagnostic level. Methods The findings of MSCT imaging in 9 cases with pathologically proved SPTP were analyzed retrospectively. One patient was male, 8 patients were female, age from 10 to 52 years old, with average of 32 years old. All patients were underwent CT plain scans and multiple phase enhanced scans. Results 6 tumors were located in tail of pancreas,2 in head and 1 in body. 8 lesions were oval and 1 lesion was lobular, with the diameter ranging from 4.7 to 12.0 cm (mean 6.8cm). 6 cases were solid-cystic tumors, 2 cases were cystic tumors and 1 was pure solid tumor. Hemorrhages were seen in 4 cases on CT images. Calcification were seen in 6 cases, with patchy calcification around in 5 cases, and eggshell calcification in l case. The solid part of the tumors were enhanced slightly in the arterial phase and markedly in the portal venous phase, presenting gradual and central enhancement. Conclusion There are some characteristics on MSCT findings of SPTP. The correct imaging diagnosis is possible based on clinical characteristic and CT findings.

【关键词】实性假乳头状瘤;胰腺肿瘤;MSCT

【中图分类号】R735.9

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2015.06.015

前言

胰腺实性假乳头状瘤(solid pseudopapillary tumor of the pancreas, SPTP)是一种少见良性或 低度恶性肿瘤,约占胰腺肿瘤的1%~2%[1]。SPTP好发 于年轻女性,手术切除预后良好。SPTP由 Frantz于 1959年首先报道,过去命名混乱,直到1996年WHO将 其正式命名为实性假乳头状瘤。近10年来SPTP发病有 增多趋势,认为主要与病理学对肿瘤认识加深、影像 学技术的发展有关。SPTP的人群分布、病理学特征和 影像学表现具有相对性特征。本文回顾性分析经病理证实9例SPTP,分析其MSCT的表现特征,旨在提高其 术前诊断水平。