胰腺异位副脾的CT、MRI诊断进展

CT and MRI Diagnosis Progress of Intrapancreatic Accessory Spleen

副脾是脾常见的先天变异,胰尾部为副脾第2常见发生部位,但胰腺异位副脾(IPAS)的影像学报道并不多见。IPAS常无明显临床症状且无需特殊治疗,因此,正确认识IPAS的CT、磁共振表现以及与其他胰腺占位性病变的鉴别如胰腺神经内分泌肿瘤、转移瘤非常重要,从而避免不必要的有创检查或手术。IPAS在CT、磁共振上与脾脏表现相似、增强扫描早期IPAS的不均匀强化有助于诊断。超顺磁性氧化铁(SPIO)增强磁共振扫描时T2WI上IPAS信号下降有助于确诊。

Accessory spleen is a common congenital anomalies and the tail of the pancreas is the second most common location of accessory spleen. However, intrapancreatic accessory spleen （IPAS） imaging result has been rarely reported. IPAS usually poses no clinical manifestations and generally does not require therapy. Therefore,it is of great importance to recognize the CT, MR imaging findings of IPAS and the differentiations between IPAS and other type of mass-occupying lesions such as neuroendocrine tumors or metastases in the pancreas so as to obviate unnecessary invasive examination or surgery. Similar imaging feature of IPAS to the spleen and characteristic heterogeneous contrast enhancement of IPAS at the early stage are diagnostic clues. Besides,it is helpful to confirm the diagnosis that IPAS shows a significant signal drop on the super- paramagnetic iron oxide （SPIO）-enhanced T2WI.