摘要
目的总结胰腺异位副脾（IPAS）的多层螺旋CT（MDCT）征象，提高对该病的认识和诊断正确率。方法收集术前行MDCT检查并经手术和病理确诊的7例IPAS患者资料，回顾性分析IPAS的MDCT特征性表现，包括病变的位置、大小、形态、边界、密度、强化特点。结果本组男性4例，女性3例，平均年龄49岁。所有病灶均位于胰腺尾部被膜下胰腺实质内偏背侧。病灶呈类圆形3例，椭圆形4例，边界清晰。病变均为实性结构，内无坏死区，未见钙化灶。病灶最大直径0．9～1．8cm，平均为1．4cm。与胰腺实质相比，CT平扫时肿块实质密度均较均匀，动脉期呈不均匀稍高密度3例，均匀稍高密度4例，门脉期均呈均匀稍高密度。平扫时肿块cT值范围50～61HU，平均55HU；动脉期CT值范围80～110HU，平均97HU；门脉期CT值99～120HU，平均102HU。行血管成像的3例患者，不管是动脉还是静脉均未见受压、被侵犯征象，未见有血管与病灶相连。结论IPAS具有特征性的MDCT影像表现，对于胰腺尾部较小实性病灶，其密度及强化方式与脾脏相似时应考虑IPAS的可能。
Objective To summarize the imaging features of intra-pancreatic accessory spleen （IPAS） with multidetector computed tomography （MDCT） and improve the awareness and correct diagnosis of IPAS. Methods MDCT images of seven consecutive patients with surgically and pathologically confirmed IPAS were reviewed retrospectively. The investigated features included the location, size, shape, margin, density, and enhancement of the lesions. Results Four patients were male and three were female with a mean age of 49 years old. All the lesions were located at the dorsal side of parenchyma under the capsule of pancreatic tail. Three lesions were in round-like shape, and 4 in oval shape and all were well-defined. All the lesions were mass-like without necrosis and calcification. The maximum diameter of lesion ranged from 0.9 ～ 1.8 cm with a mean value of 1.4 cm. Compared with pancreatic parenchyma, the density of lesions were homogeneous on unenhanced CT, in arterial phase, slightly increased heterogeneous density was observed in 3 patients, slightly increased homogeneous density was observed in 4 patients. All the lesions appeared as slightly increased homogeneous density in portal phase. The CT value in unenhanced phase ranged from 50 ～ 61 Hu with a mean number of 55 Hu; and it ranged from 80 ～ 110 Hu with a mean number of 97 Hu in arterial phase; and the corresponding value was from 99 - 120 Hu with a mean number of 102 Hu in portal phase. Among the three patients underwent MDCT angiography, neither artery nor vein was compressed or invaded, and there was no vessel connected with lesions. Conclusions IPAS has some MDCT characteristics. For small solid mass in pancreatic tail, if the density and enhancement pattern is similar to that of spleen, the diagnosis of IPAS should be considered.
出处
《中华胰腺病杂志》
CAS
2013年第2期107-109,共3页
Chinese Journal of Pancreatology
关键词
胰腺
副脾
异位组织
体层摄影术
X线计算机
Pancreas, intrapancreatic accessory spleen
Choristoma
Tomography, X-ray computed
