胰腺实性假乳头状瘤的影像学分析

Imaging Analysis of Solid Pseudopapillary Tumor of Pancreas

目的:分析胰腺实性假乳头瘤的影像学表现,提高其术前诊断率。方法:回顾性分析经手术、病理证实的5例胰腺实性假乳头瘤的影像表现和特征。结果:肿瘤绝大多数来源于胰腺,呈圆形、卵圆形,多有完整包膜,与胰腺分界清晰。CT、MRI表现为肿瘤内有实性结构和囊性结构,根据囊实性结构成分的比例可分为3型。CT平扫呈不均匀囊实性,实性结构为不规则状或乳头状,中心囊性部分密度较低。增强扫描肿瘤实性部分动脉期轻度强化,实质期呈中等或明显强化,呈渐进性强化。肿瘤斑线样外周钙化2例。MRI扫描显示胰腺边缘清晰囊实性肿物,T1WI上呈不均匀等-低混杂信号,T2WI呈不均匀混杂高信号。增强扫描肿瘤实性部分和囊壁强化。结论:SPTP具有一定的临床、CT及MR影像学特征,有助于医师做出正确诊断。

Purpose：To analyze the imaging manifestations of solid pseudopapillary tumor of the pancreas,and to improve the presurgical diagnosis.Methods：Imaging manifestations and features of five cases SPTPs confirmed by operation and pathology were retrospectively analyzed.Results：Most tumors occurred in the pancreas,and presented as round or oval in shape,and with completely encapsulated and well-circumscribed margins.On CT and MRI,the lesion presented as a mass containing both solid and cystic components.The disease could be divided into three types according to the ratio of the solid and cystic components.On plain CT scan,the tumors appeared as huge solid-cystic masses,the solid areas were with papillary or irregular components,and the cystic areas in central were with low attenuation.On contrast-enhanced CT,the cystic wall and solid part were slightly enhanced on arterial phase,and moderately or obviously enhancement on parenchymal phase.Linear peripheral calcification could be seen in two cases.MRI showed a solid-cystic mass at the pancreas with distinct border on T1WI.The mass was heterogeneous iso-and hypo-signal intensity on T1WI,and was mixed hypo-iso-and hyper-signal intensity on T2WI.The solid portion and the cystic wall were enhanced after gadolinium was administered.Conclusion：There are some characteristics in clinic,CT and MRI findings in SPTP,which can help us to reach a proper diagnosis.