男性胰腺实性假乳头状瘤的MRI表现

MR Imaging Features of Solid Pseudopapillary Neoplasm of Pancreas in Male Patients

目的探讨男性胰腺实性假乳头状瘤（SPN）的MRI征象,提高对该病影像征象的认识。方法回顾性分析经手术后病理确诊为胰腺SPN的9例男性患者的MRI资料,并复习既往文献报道。结果肿瘤位于胰头3例,胰体1例,胰体尾2例,胰尾3例;肿瘤最大径为5.25-13.85 cm,平均为（9.75±3.55）cm,其中4例最大径〉10 cm;肿瘤呈分叶状5例,类圆形3例,不规则形1例;以实性成分为主型2例,囊实型6例,囊性成分为主型1例。MRI显示肿瘤实性成分T2WI抑脂序列呈稍高信号,T1WI呈等/稍低信号,DWI呈高信号。动态增强扫描8例呈渐进性强化,平衡期强化程度与周围正常胰腺相仿;1例各期均呈轻度强化。囊性成分T2WI呈高信号,T1WI呈低信号,增强扫描各期均无强化。8例肿瘤在T1WI上见斑点、斑片状高信号区,提示肿瘤内出血,相应区域T2WI呈低信号或环状低信号,4例可见液血平面。9例肿瘤在T1Wl及T2WI上均见等/低信号包膜,增强扫描不同程度强化,3例包膜强化程度高于正常胰腺实质。结论男性胰腺SPN的MRI表现具有一定特征性,通过对其认识有望提高诊断正确率。

Objective To explore the magnetic resonance imaging（ MRI） findings of solid pseudopapillary neoplasm（ SPN） of the pancreas in male patients. Methods The MRI images 9 cases of solid pseudopapillary neoplasm of the pancreas in male patients,which were confirmed by pathology after surgery,were analyzed retrospectively. Results 9 patients with age ranging from 28 to 65 and an average age of 48 ± 17. 1. 3 lesions were located in the pancreatic head,1 in the body,2 in the body-tail and 3 in the tail. The maximum diameter range from 5. 25 cm to 13. 85 cm,and the average was（ 9. 75 ± 3. 55） cm,including 4 cases with the maximum diameter 10 cm. 5 masses with a lobulated contour and round 3 cases and irregular in 1 case. 2 cases were solid-predominance type,6 cases solid-cyst type,1 case was cystic-predominance type. Solid tumor components T1WI showed isointensity or slightly lower signal,T2WI showed isointensity or slightly higher signal,enhanced scan showed progressive enhancement pattern in 8 cases. Cystic component showed T1WI low signal and T2WI high signal,without enhancement. Patch of high signal was found on T1WI and low signal on T2WI in 8 cases,which suggest hemorrhage in the tumor,and 4 cases showed fluid-blood level. Tumor capsule showed low signal or isointensity on T1WI and T2WI,enhanced scan showed different degrees of enhancement,3 cases were higher than the normal pancreatic parenchyma. Conclusion There are certain characteristics of solid pseudopapillary tumors of pancreas in male patients on MR imaging. The diagnostic accuracy can be improved if we understand the characteristic imaging findings.