胰腺实性假乳头状瘤的CT、MRI表现及病理对照

CT and MRI features and pathologic diagnosis of solid pseudopapillary tumor of pancreas

目的：探讨分析胰腺实性假乳头状瘤（solid pseudopapillary tumor of the pancreas,SPTP）的CT、MRI表现特点,提高对该病的认识。方法：回顾性分析经手术病理证实的9例SPTP患者（8例女性、1例男性）的临床和影像学资料。其中7例行CT平扫及增强扫描,2例行MRI平扫及增强扫描。结果：9例患者均为单发囊实性病灶,最大直径4.3~11.6 cm,平均约7.2 cm,大部分边界较清晰。其中实性成分为主者3例,囊性成分为主者2例,实、囊成分比例相仿者4例。7例CT显示病灶密度高低不均匀,其中3例可见钙化灶,2例病灶MRI信号混杂,以长T1、长T2信号为主,包膜在T1WI和T2WI均呈低信号。实性成分及包膜在增强扫描中均呈渐进性明显强化。结论：胰腺实性假乳头状瘤影像表现具有一定的特征,术前的明确诊断对手术方式的选择及预后的评估有着重要的意义。

Objective To analyze the CT, MRI characteristics of pancreatic solid pseudopapillary tumor （SPTP）, and to im- prove the understanding of this disease. Methods A retrospective analysis of nine patients （eight women and one man） pathologically confirmed with SPTP was performed for the clinical and imaging data, of which, seven ones went through CT scan and enhanced scan and two ones though plain and enhanced MRI scans. Results Single cystic-solid lesions were found in the nine patients, with the maximum diameter ranging from 4.3 to 11.6 cm and the average diameter of 7.2 cm. Almost all the lesions had clear boundaries, with three cases with dominant solid components, two cases with dominant cystic components and four cases with similar ratios of solid and cystic components. Seven patients were found by CT scan having the lesions with uneven intensities, of which there were 3 ones with calcification loci. Two patients had the lesions with mixed MRI signals, with long T1 and long T2 signals taking the leading position; the capsules showed low signals at T1WI and T2WI; enhanced scan showed that the solid components and capsules progressive enhancement. Conclusion Pancreatic solid pseudopapillary tumor imaging findings have certain characteristics, and preoperative diagnosis is important for the choice of surgical approach and prognostic evaluation.