胰腺实性-假乳头状瘤影像学诊断

Imaging diagnosis of solid-pseudopapillary tumors of the pancreas

目的探讨胰腺实性-假乳头状瘤(SPTP)的CT及MRI影像诊断。方法回顾分析经手术和病理证实的10例SPTP的CT及MRI影像学表现。结果(1)SPTP多见于年轻女性,临床表现多为腹部不适、腹痛,或无明显临床症状;(2)肿瘤内为实性和囊性结构,按实性和囊性结构比例分3型:囊性、实性、囊实性;影像学特征性表现为"浮云征",实性部分平扫呈低或等密度,动脉期轻度强化,门脉期中度或明显强化,囊性部分无强化;(3)SPTP为交界性肿瘤,与胰腺分界清楚,预后良好;(4)胆总管和胰管不扩张;(5)肿瘤边缘偶可有钙化。结论SPTP虽然罕见,但其CT及MRI表现有一定特征性,影像科医生应努力提高术前定性诊断的正确率。

Objective： To study the CT MRI diagnosis of the solid-pseudopapillary tumors of pancreas （SPTP）. Methods： CT MRI features of ten patients with pathologically proved SPTP were retrospectively analyzed. Results： （1） The disease mainly occurred in young women, with abdominal pain discomfort or no symptoms as the chief complaint. （2） On CT and MRI, the lesion were shown as a mass containing both solid and cystic components. The disease could bed divided into three types： cystic, solid and cystic-solid. The feature was ＂floating cloud＂ sign. The solid portions demonstrated hypo-or iso-attenuafion on pre-contrast CT, and slight enhancement in the arterial phase and midrange or marked enhancement in the portal venous phase on post-contrast CT scan. The cystic portions showed hypo-attenuation on both pre-and post-contrast views. （3） SPTP was a borderlining tumor, which was well-demarcated from the adjacent pancreatic tissue, and its prognosis was excellent. （4） There was no associated dilatation of the common bile duct or pancreatic duct. （5） Calcification was occasionally noticed in the cystic wall. Conclusion： Although SPTP is rare, there are characteristics of SPTP of the pancreas in the CT and MRI manifestations and the doctors should try their best to improve the ratio of SPTP＇s correct diagnosis before surgery.