胰腺实性-假乳头状瘤的CT诊断与病理分析

Diagnosis of solid pseudopapillary tumors of the pancreas by CT: comparison with pathological findings

目的：分析胰腺实性假乳头状瘤（SPTP）的CT表现,并与病理结果对照分析,旨在提高对该病的认识和诊断。方法：回顾性分析6例经手术和病理证实的胰腺实性假乳头状瘤的临床及CT表现,将CT表现与临床及病理对照。结果：SPTP好发于20-40岁女性,胰头及胰尾为好发部位,影像学表现为境界清楚的圆形或类圆形胰腺肿块,瘤体通常比较大（〉5cm）。平扫主要表现为囊实性混杂密度影,实性结构边缘分布为主,部分呈乳头状或壁结节样突起。动态增强后实性部分早期轻度强化,后期呈渐进性强化,6例肿瘤均有包膜,多伴有出血及囊变,所有病灶无论大小及在胰腺中的位置,均未见胰管及胆管扩张,腹腔淋巴结肿大及远处转移罕见。结论：胰腺实性假乳头状瘤影像学表现具有相对特征性,CT对其诊断有重要价值。

Objective：To analyze the imaging appearances,in comparison with the pathological findings so as to enhance the imaging diagnosostics of solid pseudopapillary of pancreas（SPTP）.Methods：Six cases of pathdogically proven SPTP were included in this retropective work.Imaging features were compared with pathological findings.Results：The disease mainly occurred in females aged between 20～40 years old.Pancretic tail and head were the prevailing sites of tumor involement on CT,the lesions presented as well-defined round and oval shaped masses.On non-enhanced CT,the lesions appeared as heterogeneous density/signal intensity masses because of their components consisting of solid and cystic ones.The solid portions of the tumors were often located at the periphery of the masses,and some of them showed the shapes of nipple or mural nodular processes.After contrast administration,the lesions demonstrated mild peripheral heterogeneous enhancement in arterial phase with progressing filling during the later phases.All tumors possessed capsules.Some of the tumors involved intratumoral hemorrhage and cystic degeneration,the tumors neither dilatation of biliary tract nor pancreatic ducts were found probably because of the tenderness of the tumors.Metastatic adenopathy of abdominal cavity and remote metastasis of lymph nodes were rare.Conclusion：Certain imaging diagnostic characteristics of SPTP can be demonstrated with CT, which is of great importance in the diagnosis of the disease.