摘要
目的描述胰腺实性-假乳头状瘤(solid-pseudopapillary tumor of pancreas,SPTP)的影像学表现,探讨影像学诊断本病的价值。方法回顾性分析经手术病理证实的7例SPTP影像学表现。7例均行CT平扫和双期增强扫描,其中3例行胃肠道钡餐检查,3例行超声内镜检查,1例行MRI检查。结果SPTP表现为不均匀囊实性或囊性肿块,有包膜,边界清楚。胃肠道钡餐主要表现为胃、十二指肠壁的受压、移位。超声表现为高回声肿块,内有散在液性暗区,包膜呈高回声。CT平扫6例为低密度囊实性肿块,内可见多种形态、大小范围不同的更低密度区,1例为有壁结节的囊性肿块。肿块钙化2例。增强后动、静脉期肿块主要表现为边缘部不均匀强化,其内更低密度区及囊性部分无强化。3例明显强化,其中1例动脉期可见肿瘤内大量迂曲细小血管影,4例轻度强化。3例包膜表现为间断的弧线状强化。MRI表现为T1WI上以等信号为主,中央及边缘部夹杂高低混杂信号,T2WI呈稍高信号为主,夹杂高低混杂信号。包膜T1WI、T2WI上均呈低信号。胆管轻度扩张2例,胰管轻度扩张2例。结论CT、MRI能较好地反映SPTP的特征,是术前诊断本病的主要方法。
Objective To describe the imaging features of solid-pseudopapillary tumor of the pancreas（SPTP） and evaluate the value of imaging in diagnosing SPTP. Methods The imaging appearances in seven cases of SPTP confirmed by surgery and pathology were analyzed retrospectively. The un-enhanced and biphasic enhanced CT scanning were performed on all seven cases, including gastrointestinal barium meal series on three cases, endoscopic ultrasonography （EUS） on three cases, and MRI on one case. Results All tumors presented well-encapsulated heterogeneous soft tissue mass with varying degrees of solid and cystic components. Barium meal examination showed displaced gastrointestinal wall due to the tumoral compression. EUS demonstrated hyper-echoic mass with scattered small anechoic areas within the tumor. The tumor capsules were hyper-echoic. On un-enhanced CT, the mass appeared hypo-dense with mixed solid and cystic portions in six cases, and with predominantly cystic portion in one case. Calcification appeared in two cases. On biphasic en- hanced CT, the mass showed peripheral and heterogeneous enhancement. Three tumors showed marked enhancement, and four tumors showed mild enhancement. Multiple small vessels within the tumor revealed on the arterial phase scanning in one case. The tumor capsules showed discontinuous enhancement in three cases. On T1WI, the mass appeared heterogeneous and predominantly isodense. On T2WI, the mass appeared heterogeneous and predominantly hyper-dense. The tumor capsule was hypo-dense on T1WI and T2WI. The mild dilatation of the biliary tract and pancreatic duct was revealed in two cases, respectively. Conclusion Both CT and MRI can describe characteristic features of SPTP well, and should be used as the main diagnostic methods for SPTP before operation.
出处
《影像诊断与介入放射学》
2007年第6期264-267,共4页
Diagnostic Imaging & Interventional Radiology
关键词
胰腺
肿瘤
体层摄影术
X线计算机
磁共振成像
诊断显像
Pancreas
Eoplasm
Tomography, X-ray computed
Magnetic resonance imaging
Diagnostic imaging
