胰腺体尾部癌的影像学表现

Imaging Findings of Carcinoma of Body and Tail of Pancreas

目的总结胰腺体尾部癌的影像学表现。方法对经手术及病理证实的23例胰腺体尾部癌的影像学资料进行分析,包括肿瘤的部位、大小、形态、质地、强化方式和与周围结构的关系。其中5例患者行MRI增强扫描,18例患者行螺旋CT增强扫描。结果 23例患者中,病灶位于体部5例,尾部7例,体尾部11例。CT表现为胰腺体尾部实质内不规则肿块,密度稍低,混杂不均;MRI肿块表现为T1WI略低或低信号,T2WI为略高或混杂信号。19例增强后不均匀轻度强化,4例增强后强化不明显。5例边界清晰,18例边界模糊。16例出现周围淋巴结转移,8例周围血管受累。3例出现脏器及骨转移。结论胰腺体尾部癌具有一定的影像学特征,CT和MRI扫描可以充分反映肿块的形态、血供特点及周围蔓延情况。

Objective To investigate the imaging findings of carcinoma of body and tail of the pancreas.Methods Totally twenty-three patients with carcinoma of body and tail of the pancreas were studied.The diagnosis was proven by surgery and pathological findings.The imaging features of twenty-three cases were reviewed including the location,size,shape,texture,and enhancement patterns of the tumor masses.Five cases underwent enhanced MRI examination,18 cases underwent enhanced spiral CT examination.Results The tumors located in the pancreatic body in 5 cases,located in the tail in 7 cases,and located in the body and tail of pancreas in 11 cases.The tumor masses were irregular in shape and heterogeneously hypointense from CT scan.From MR,the masses were slightly hypointense on T1WI,and slightly or mixed hyperintense on T2WI.Nineteen cases showed heterogeneous slight enhancement and four cases had no enhancement.The tumors were well demarcated in five cases,while those were poorly defined in the other 18 cases.Metastatic lymphadenopathy was shown in 16 cases,vascular invasion in 8 cases,and metastatic lesions of other organs in 3 cases.Conclusion The carcinoma of body and tail of the pancreas shows certain characteristic imaging.CT and MRI examination can reflect the morphologic features,the hemodynamic alterations,and the involvement of adjacent structures and organs.