摘要
目的:探讨异位胰岛细胞瘤的多层螺旋CT(multi-slice spiral computed tomography,MSCT)表现及其诊断价值。方法:回顾性分析6例经手术及病理证实的异位胰岛细胞瘤的影像资料,6例均行MSCT动态增强双期扫描,其中功能性胰岛素瘤2例,非功能性胰岛细胞瘤4例。结果:本组6例共7个肿瘤,多发1例,位于肝十二指肠韧带及十二指肠降段浆膜下;5例单发,其中胃大弯1例,脾门2例,腹膜后2例。肿瘤呈膨胀性生长5例,其中圆形及类圆形1例,不规则分叶状2例,巨大肿块2例;另1例呈弥漫性结节形。MSCT平扫肿瘤为等密度,5例密度不均匀,伴有坏死或囊变区;增强扫描肿瘤呈中度以上明显强化,坏死囊变区无强化。淋巴结转移4例,其中脾门2例,大网膜及肠系膜根部各1例。所有病例胰腺均无肿大及异常强化肿块影,肿瘤与胰腺间有薄层脂肪间隙存在。结论:异位胰岛细胞瘤的MSCT表现具有一定的特征性。MSCT双期扫描对异位胰岛细胞瘤术前定位及其良、恶性的判断有重要临床意义,有助于指导临床治疗方案的制定。
Objective：To investigate the multi-slice spiral CT（MSCT） features of heterotopic pancreatic islet cell tumors（HPICTs） and its diagnostic value.Methods：Six surgically and pathologically confirmed HPICTs were studied with retrospective analysis.All 6 cases underwent MSCT dynamic dual-phase scanning,in which 2 cases were functional insulinoma,4 cases were non functional islet cell tumors.Results：Of 6 patients with 7 tumors,1 case was multiple of 2 tumors,localized in the hepatoduodenal ligament and the descending duodenum subserosal,5 cases were solitary,localized in the greater curvature of the stomach in 1 case,in the retroperitoneal space in 2,in the splenic hilum,in 2.The tumors showed expansive growth in 5 cases,among them round and round in 1,irregular lobulated in 2,a huge mass in 2,the other 1 case of stomach showed diffuse nodular form.All tumors appeared medium density on MSCT scannings,5 cases appeared uneven density,accompanied by necrosis or cystic areas,on dual-phase enhancement scannings,all tumors showed moderate or high enhancement,cystic lesions without enhancement.There were 4 cases with lymph node metastasis,including 2 cases of splenic portal,1 case of greater omentum and the other 1 of mesentery root.Pancreases of all cases were no enlargement,no abnormal enhancement of mass.There were thin fat clearances between the tumors and pancreases.Conclusion：The MSCT features of HPICTs have certain characteristics,dual-phase enhancement scannings have important clinical significance on the preoperative localization of HPICTs and its benign,malignant judgements,can help to guide the clinical treatment.
出处
《现代肿瘤医学》
CAS
2013年第8期1855-1857,共3页
Journal of Modern Oncology
