胰腺实性-假乳头状瘤的影像学诊断

Imaging diagnosis of solid psedopapillary tumor of pancreas

目的回顾性分析与总结胰腺实性-假乳头状瘤的影像学特点。方法搜集7例经手术病理证实为胰腺实性-假乳头状瘤病例的影像学资料,6例术前行CT检查,1例行MR检查。结果肿块体积较大,最大径为2．8～15．9 cm,平均7．9 cm；术前CT或MR检查,5例可观察到包膜,另2例亦边界清楚,病理标本中6例可见完整包膜,仅1例包膜部分被侵犯；6例行CT检查患者中,3例肿块边缘见钙化灶,其中2例包膜内见散在点线状钙化灶,另1例钙化灶亦位于肿块边缘；除1例几乎完全为实性成分,其余6例均为囊实性；CT检查,部分囊实性成分中见散在片状高密度,MR检查,T_1WI显示实性成分呈高信号,均提示肿块中出血可能,术后病理亦证实。结论胰腺实性-假乳头状瘤具有相对特征性的临床及影像学表现。

Objective To retrospectively analyze and conclude the characteristics of imaging appearances of solid psedopapillary tumor of pancreas. Methods Among 7 cases with pathologically proved solid psedopapillary tumor of pancreas, 6 cases underwent CT examinations of upper abdomen preoperatively, and the rest One had MRI examination. The mean age of these 7 cases （ all female） was 30.7 years （range, 14-44 years）. Results The tumors were usually quite large in the largest diameter ranged from 2. 8 to 15. 9cm （mean largest diameter, 7.9 cm） ; Tumors were all well demarcated, and 5 of them were of capsule on CT or MR imaging. All tumors were well-encapsulated on pathologic specimens, except for the capsule of 1 tumor was partially invaded; In 6 cases underwent CT examination, scattered, punctate and linear calcification were noted in the capsule of 2 tumors and the rim of another one ; Except for 1 tumor was almost solid, the other 6 tumors contained both solid and cystic components; Scattered sheets of high attenuation shown in the cystic or solid parts on CT imaging in several cases and the high signal intensity on T1-weighted MR imaging signified the possibility of bleeding in tumors, which then was testified by pathologic evaluation. Conclusion The solid psedopapillary tumor of pancreas has comparatively characteristic clinical and imaging features.