MSCT检查在胰腺假乳头状瘤术前诊断中的应用价值

The Application of MSCT on Pre-Operative Diagnosis for Solid-Pseudopapillary Tumors of Pancreas

[目的]探讨胰腺实性假乳头状瘤术前MSCT检查影像学特点。[方法]回顾性分析16例经手术后病理证实胰腺实性假乳头状瘤CT表现的临床资料。[结果]本组16例中11例囊实性比例相仿,囊性结构为主4例,实性结构为主1例。CT平扫实性部分呈低或等密度,增强后动脉期呈轻度强化,门静脉期呈明显强化,囊性部分在增强前后均未见强化呈低密度。9例病灶均有完整包膜,7例包膜欠完整。16例中,1例行胰十二指肠切除术,1例行肿瘤局部切除加胰尾部切除术,6例行胰腺尾部加脾脏切除,7例行单纯肿瘤局部切除术。[结论]胰腺实性假乳头状瘤MSCT增强检查具有相对特征性;术前行MDCT增强检查、三维重建可帮助了解肿瘤与周围脏器的关系,对协助手术方案的制定有重要的价值。

[Purpose] To investigate the multi-slice spiral CT（MSCT） manifestations of solid-pseudopapillary tumors of pancreas（SPTP）.[Methods] MSCT features and clinic data of 16 patients with SPTP pathologically proved were retrospectively analyzed. [Results] Of 16 cases,11 tumors were composed of similar proportions of solid and cystic parts,and 4 tumors were mainly composed of cystic parts,and 1 tumor was mainly composed of solid parts. The solid portions demonstrated hypo-or iso-attenuation on pre-contrast MSCT,and slight enhancement in the arterial phase and marked enhancement in the portal venous phase on post contrast MSCT scan. The cystic portions appeared hypo-attenuation on both pre-and post-contrast views. 9 cases with intact encapsular,7cases with incompletely encapsular and marked enhanced with well defined margins on post-contrast images. Of 16 patients,1 patient underwent pancreaticoduodenectomy;6,underwent distal pancreatectomy plus spleen resection; 1,underwent distal pancreatectomy plus simple tumor resection, and 7,simple tumor resection. [Conclusion] The MSCT enhancement examination shows the characteristic findings of SPTP might be of great value for the clinical diagnosis. MSCT imaging reconstruction is helpful to know the tissues along the tumor,and helpful to make surgical plan.