胰腺实性假乳头状瘤的CT表现并文献复习(附5例报告)

The CT Feature of Solid Pseudopapillary Tumor of Pancreas and Literatures Review:5 Cases Report

目的分析胰腺实性假乳头状瘤(solid pseudopapillary tumor of pancreas SPTP)的CT征象,探讨CT对肿瘤的诊断价值。方法回顾性分析5例经手术病理证实的SPTP患者的CT资料并复习文献。结果 5例患者均为女性,年龄17-45岁。CT显示病灶均为单发,呈圆形或椭圆形,大小约5-12cm。胰头部3例,胰体部1例,胰体尾部1例。肿块密度不均匀,呈囊实性,1例实性、囊性成分相当,其余4例均以囊性成分为主。增强扫描动脉期实性部分呈轻中度强化,门静脉期呈持续性或渐进性强化特征,强化程度较正常胰腺实质稍低,囊性部分未见强化,纤维包膜呈均匀强化,1例包膜显示不完整,2例病灶包膜有点状钙化,1例伴有胰管轻度扩张,1例伴有肝右叶后下段(S6)低密度,术后8个月复查,病灶最大径增大约3.6mm。结论胰腺实性假乳头状瘤的CT表现有一定的特征,有助于SPTP的术前诊断。

Objective To analyze the CT manifestation of the solid pseudopapillary tumor of pancreas（SPTP） and to explore the diagnostic value of CT. Methods Both corresponding literatures review and retrospective method were applied to analyze the data of CT images from five cases of SPTP confirmed by operation and pathology. Results 5 female patients, aged from seventeen to forty-five were proved single lesion with tumor diameter of 5-12 cm. Among the five cased three focued on the head of pancreas, one on the pancreatic body, and the last on the pancreatic body-tail. The lesion presented as round or oval in shapes which oppress surrounding round tissues and organs to a certain extent. Solid and cystic structures were exposed within the neoplasm.1 tumor was composed of similar proportions of solid and cystic parts, and 4 cases were mainly composed of cystic parts. Reinforced performance for a substantial part of the arterial phase leads to a slight-moderate enhancement, and progressive enhancement was occurred in the portal venous phase. Enhanced solid part bears a little lower enriched degree than normal pancreatic parenchyma. The cystic portions appeared hypo-attenuation on both pre-and post-contrast views Homogeneously reinforcement was found in the fibrous capsule. Of all five masses, 1 case was incomplete capsule, 2 cases were calcified capsule, 1 with slight pancreatic duct and the last one with the low density in the latter part of the right lobe of liver（S6）. The reexamine eight months after the treatment, the lesion was about 3.6mm larger than before. Conclusion The CT findings of SPTP is helpful to the accurate preoperative diagnosis of the disease.