非常见胰腺肿瘤的超声表现

Ultrasonic findings of uncommon pancreatic neoplasms

目的探讨非常见胰腺肿瘤的超声表现及临床特点。方法分析总结28例不同病理类型的非常见胰腺肿瘤的超声表现,包括肿瘤声像图特点、与周围血管脏器的关系、肝内外胆管和胰管有无扩张及是否出现黄疸。其中3例进行了超声造影检查。结果 28例均经手术病理证实包括实性假乳头状瘤10例、转移癌6例、无功能性胰岛细胞瘤5例、功能性胰岛细胞瘤5例、导管内乳头状瘤2例。它们在超声声像图上各有其特征性表现,在临床上无黄疸及周围血管脏器的浸润,与原发性胰腺癌表现明显不同。超声造影检查中,2例功能性胰岛细胞瘤动脉相及静脉相均呈高增强;1例转移癌动脉相为高增强,静脉相呈低增强。结论超声特征性表现有助于诊断不同病理类型的非常见胰腺肿瘤,超声造影为鉴别诊断提供了更多的信息。

Objective To discuss the ultrasonic and clinical features of uncommon pancreatic neoplasms （UPCNs）. Methods A retrospective review was performed in 28 UCNPs. The study included the echo texture of tumor, relationship with vessel, bile duct, pancreatic duct and jaundice. The ultrasonic features were summarized. Three of 28 cases performed contrast-enhanced ultrasound（CEUS） examination. Results All the 28 cases were proved by pathologic results including 10 solid pseudopapillary tumor （SPT）,6 metastasis tumors, 10 islet cell tumors （5 functioning and 5 non-functioning） and 2 intraductal papillary mucinous tumors, respectively. The ultrasonic findings were different according to different pathologic types of UCNPs. No jaundice and invasion of the surrounding vessels were detected in all cases. These findings were different from the primary pancreatic adenocarcinoma. By CEUS, 2 functioning island cell tumors showed hyper-enhancement at all phases, 1 metastasis tumor showed hyper-enhancement at arterial phase and hypo-enhancement at venous phase. Conclusion The ultrasonic findings were characteristic according to different pathologic types in UCNPs. CEUS can provide more findings of differentiation.