摘要
目的探讨胰腺实性假乳头状瘤(solid-pseudopapillary tumor of pancreas,SPTP)的螺旋CT及高场强MRI表现。资料与方法回顾性分析21例经手术病理证实的SPTP影像学资料。21例中,男2例,女19例,年龄12～57岁,中位年龄34.5岁,男女比例1∶9.5。19例行薄层胰腺CT,13例行MRI,其中6例行磁共振胰胆管成像(MRCP),10例患者接受CT联合MRI。结果 21例肿瘤均为单发,14例肿瘤边界清楚,15例呈类圆形,6例呈团块状,其中3例呈分叶征象。CT平扫,10例肿瘤密度稍低或明显低于胰腺组织,3例肿瘤内局部密度高于胰腺组织,2例肿瘤钙化,6例囊实性混杂密度。MRI脂肪抑制T2WI上3例呈高低混杂信号,9例呈稍高、中等高信号,1例呈均匀极高信号,4例肿瘤边缘可见环形细线状包膜低信号,T1WI上4例呈高低混杂信号,6例呈低信号,2例呈高信号,1例呈等信号(与胰腺信号相仿)。CT和MR动态增强扫描动脉期肿瘤均有不同程度强化,门静脉期和延迟期肿瘤仍持续强化,CT延迟期病灶与胰腺组织有"杯口"状分界,MRI门静脉期及延迟期肿瘤中央和囊性部分无强化。MRCP示胆总管扩张1例,胰管扩张1例。1例术后复发者为外生性分叶状肿块,肿块最大径10.5cm,伴局部钙化,与周围组织界限欠清,增强后肿块内见直径0.7cm的小斑片状囊性无强化区。21例定期行影像学检查,平均随访时间40个月,2例出现肝脏转移,生存率为100%。结论平扫、动态增强螺旋CT及高场强MRI和MRCP能反映SPTP的影像学特点,提高了该病的诊断准确率。
Objective To evaluate the CT and MRI findings of solid-pseudopapillary tumor of pancreas （SPTP）. Materials and Methods 21 cases with pathologically confirmed solid-pseudopapillary tumor of pancreas were analyzed retrospectively.The patients included 2 males and 19 females with mean age of 34.5 years （range 12-57）,the ratio of male to female was 1 to 9.5.19 cases were examined with sheet pancreatic CT,13 cases were examined with MRI,6 cases were examined with magnetic resonance cholangiopancreatography （MRCP）,10 cases （10/21 cases） received both CT and MRI. Results 21 cases were single tumor,14 cases of tumors had clear boundaries,15 lesions were round or oval in shape,6 cases of tumor showed lumps,3 cases （3/6 cases） showed signs of lobulated. The density of tumors in 10 cases apparently or slightly lower than pancreatic tissue on CT,the local density of lesions in 3 cases was higher than the pancreas,two cases had calcified tissues,6 cases showed mixed density with solid and cystic. On fat-suppressed MRI T2WI,3 cases showed the mixed-signal,9 cases showed slightly higher or moderately high signal,1 case showed homogeneous high signal uniformly,the margin of the tumors in 4 cases with ring-shaped linar envelopes showed low signal,On T1WI 4 cases showed mixed signal,6 cases showed low signal,2 cases showed high signal,and 1 case showed isointensity signal（similar to pancreatic signal）. All the tumors had different enhancement in arterial phase on CT and MR scans,the tumors continued to strengthen at portal vein and delayed phase. At the CT delayed phase,a cup-shaped boundaries appeared between lesions and pancreatic tissues.The central of the tumors and cystic parts had no enhancement at portal vein and delayed phase of MRI.Common bile duct and pancreatic duct dilated in 1 case separately in MRCP examination. One case recurred after operation had a exogenous lobulated mass with maximum diameter of 10.5 cm,and had partial calcification.The mass had less clear boundary with surrounding tissues,a cystic patchy area with diameter of 0.7 cm was not enhanced in this mass after enhancement. 21 patients regularly in iconography examination,the average follow-up time was 40 months （1997 to 2010）,2 patients had liver metastasis,survival rate was 100%. Conclusion Plain and dynamic contrast-enhanced spiral CT and MRI as well as MRCP appearances can reflect the SPTP imaging characteristics.
出处
《临床放射学杂志》
CSCD
北大核心
2010年第10期1345-1348,共4页
Journal of Clinical Radiology
