胰腺囊实性假乳头状瘤的CT诊断与鉴别诊断(附10例报告)

CT diagnosis of solid-cystic pseudopapillary tumor of the pancreas

目的探讨胰腺囊实性假乳头状瘤(SCPT)的CT诊断及与胰腺其他囊实性肿瘤的鉴别诊断。方法回顾性分析经手术病理证实的10例胰腺SCPT患者的影像学表现。结果5例患者肿瘤位于胰体尾部,3例位于胰头体交界区,肿块大多数较大,最大截面达10 cm×10 cm,最小3 cm×4 cm,均含囊实性成分,但大部囊性成分较多;在囊实性交界部分,实质与囊性部分呈片状相间分布。CT增强扫描动脉期实质成分可见明显强化,至门静脉期肿瘤强化略高于动脉期,但强化程度均略低于正常胰腺组织。4例患者有钙化。结论胰腺SCPT的CT表现有一定特征性,结合患者临床表现并注意与胰腺癌,黏液性、浆液性囊性瘤或癌及假性囊肿等鉴别,有利于术前做出正确诊断。

Objective To study the CT features of solid-cystic pseudopapillary tumor （SCPT） of the pancreas and the discrimination with other solid-cystic tumors of pancreas. Methods Ten patients histopathologically proven pancreatic SCPT were retrospectively analyzed. Of 10 cases Results Five cases of SCPT located in the tail of pancreas, and 3 in the neck. The mean diameter of the tumors was 9.5 cm （3-10 cm）. All tumors were composed of solid-cystic portions, but mainly composed Of cystic portions. The interface of solid and cystic component is lamellar alternative distributed. The solid portions was obviously enhanced in the arterial phase, and was slightly higher in portal venous phase on post-contrast CT, but was lower than normal pancreas in both phase. Calcification was seen in three cases on CT. Conclusion There are some characteristics in CT manifestation of SCPT. The disease might be correctly diagnosed preoperatively combined with the clinical feature, and should be differentiated from pancreatic carcinoma, mucinous or serosity eystadenoma or cystcarcinoma, pseudoeyst etc.