胰腺实性假乳头状瘤的CT表现

CT profile of solid-pseudopapillary tumor of pancreas

目的分析胰腺实性假乳头状瘤(SPTP)的CT表现,提高正确诊断率。方法回顾分析经手术病理证实的21例胰腺实性假乳头状瘤,患者术前均经CT平扫及三期增强检查,复习CT影像表现并与病理结果对照。结果21例胰腺实性假乳头状瘤中13例位于胰头,8例位于体尾部,肿瘤直径2～15cm。19例与周围组织界限清,具有完整的包膜,以囊实性为主,囊最大直径4cm,囊壁厚0.2～3cm;仅2例为实性。位于胰头的肿瘤胰管及胆总管扩张不明显。CT平扫示肿瘤密度不均匀;CT增强扫描示动脉期实性部分轻度强化,门脉期及延迟期强化程度逐渐增加。结论CT对胰腺肿瘤的诊断具有一定的价值,病理变化是CT表现的基础。

Objective To analyze CT appearance of solid-pseudopapillary tumor of pancreas （SPTP） and enhance the accurate diagnostic rate. Methods Twenty one patients with surgically and pathologically confirmed SPTP were reviewed. All cases underwent unenhanced spiral scanning CT and three phases post-contrast scanning. The CT imaging was analyzed in comparison with surgical pathological features. Results Thirteen cases were located in pancreatic head, 8 located in pancreatic body and tail. The diameter of tumors were 2 - 15 cm, 19 were well-circumscribed and encapsulated, most tumor including cystic and solid portion, the largest diameter of cyst was 4 cm, the wall thickness was 0. 2 - 3 cm, only 2 were completely solid ; The pancreatic head tumors did not cause pancreatic duct and common bile duct dilate obviously. The unenhanced CT scanning showed that tumors were non-homogeneous. On post-contrast CT, the solid portion was slightly enhanced in the arterial phase and markedly enhanced in portal and delay phase. Conclusion CT was helpful in diagnosing SPTP, the appearance of CT was based on pathology.