胃及十二指肠异位胰腺10例CT特征分析

CT features of heterotopic pancreas in the stomach and duodenum

为分析胃及十二指肠肿瘤样异位胰腺的CT 及病理特征，提高临床医生对发生于胃肠道肿瘤样异位胰腺的认识和CT诊断率，对绍兴市人民医院2007年6月至2015年12月8年期间经手术病理证实的10例具有完整CT 影像资料的胃及十二指肠肿瘤样异位胰腺进行回顾性分析，观察病变位置、大小、形态及强化方式。10例病变均单发，7例发生于胃部，其中，胃窦部3例，胃体小弯侧3例，大弯侧1例；3例发生于十二指肠，其中，球部2例，乳头部1例。病灶大小（12.3 mm×6.2 mm）（24.7 mm ×16.2 mm）之间，平均约16.8 mm×10.6 mm。病灶形态9例呈卵圆形或类圆形，1例不规则。所有病例均实行双期增强扫描，增强后门脉期9例明显强化，病理结果以腺泡组织为主；1例呈囊状改变，无强化，病理结果为导管和大量增生的平滑肌。以胰腺CT值作参考，强化的9例中7例类似胰腺强化或强化后的衰减，2例无规律。胃及十二指肠肿瘤样异位胰腺CT表现具有一定的特点，其CT特征对诊断异位胰腺有重要价值。

CT findings of 10 patients with tumor-like heterotopic pancreas in the stomach and duodenum, proven by surgery and pathology between 2007 and 2015, were reviewed retrospectively.The location, size, shape and contrast-enhancement pattern were analyzed.All 10 cases were of single lesion , 7 cases were located in the stomach （3 in gastric antrum, 3 in lesser curvature, 1 in large curvature of gastric body）;3 cases were located in the duodenum （2 in duodenal bulb , 1 in duodenal papilla ）.The size of lesions was between 6.2 mm ×12.3 mm to 24.7 mm ×16.2 mm with a mean of 16.8 mm ×10.6 mm.Nine lesions were of ovoid or round in shape , 1 was of irregular shape.All cases underwent CT dual phase enhancement scanning.In the venous phase , 9 cases showed bright enhancement , which was composed chiefly of pancreatic acini in pathological examination; 1 cases of cystic shape showed no enhancement , which was composed chiefly of pancreas ducts and large amount of hyperplastic smooth muscle shown on pathology.The contrast-enhancement patterns of 7 cases were similar to those of normal pancreas; those of remaining 2 cases were in disorder.Tumor-like heterotopic pancreas in the stomach and duodenum has certain CT characteristics , which are of diagnostic value.