胰腺腺泡细胞癌的CT、MRI表现特征

CT and MRI features of pancreatic acinar cell carcinoma

目的探讨胰腺腺泡细胞癌（PACC）的影像特征。方法回顾性分析行CT和（或）MRI检查，并经手术病理证实的11例PACC患者资料。6例行CT平扫加增强扫描，3例行MRI平扫加增强检查，2例同时行CT、MRI平扫加增强扫描，观察其影像表现。结果病变位于胰头部4例、胰体尾4例、胰尾部3例。肿瘤边界清楚、瘤体最大长径27-180mm，中位最大径97mm。9例可见包膜强化。9例可见肿瘤血管。肿瘤呈乏血供的7例，富血供4例。11例均可见不同程度的旋涡状或裂隙状坏死区，坏死范围2％～25％，中位坏死范围为10％。结论PACC影像上常表现为边界清、有包膜、容易m现坏死的胰腺巨大肿物，影像表现具有一定特征性。

Objective To identify the imaging features of pancreatic acinar cell carcinomas. Methods Eleven patients of pancreatic acinar cell carcinomas proven surgically and pathologically were included. We retrospectively evaluated the CT and MR findings including the location, size, shape, margin, necrosis , calcification, hemorrhage, enhancement degree, enhancement pattern, invasion to other organs, perilesional lymph nodes, metastasis, recurrence. Results The tumors were distributed in the head（n=4）, body and tail（n=4）,tail（n=3） of pancreas. The median tumor size was 97 mm（27 to 180 mm）.Nine cases presented with a well-defined enhancing capsule. Tumor vessels could be seen in 9 cases.Seven cases were hypovascular while the other 4 were hypervaseular. Different extents of necrosis could be seen in all masses as a swirling or cleft low density in the enhanced tumors, with an median of 10% （2% to 25%）. The hypovascular masses more frequently demonstrated a lobulated tumor, heterogeneous enhancement pattern, with a larger necrotic component and were more common invasion to other organs. Conclusions Pancreatic acinar cell carcinoma typically presents as a sizable pancreatic mass with a well-defined enhancing capsule.