胰腺腺鳞癌的磁共振成像特征

MR Imaging Findings of Pancreatic Adenosquamous Carcinoma

目的探讨胰腺腺鳞癌的磁共振成像特征,提高对该病的认识。方法回顾性分析8例手术病理证实的胰腺腺鳞癌患者的磁共振图像(5例行平扫及增强检查,3例仅平扫),重点分析病变的部位、形态、磁共振信号、动态增强特征、有无血管受累及胰胆管扩张。结果位于胰头或钩突者4例,胰体4例;多为边界不清的实性肿块(7/8);增强扫描4例周边区域呈环状强化(4/5),中心区域多为弱强化,并呈渐进性强化,3例可见血管侵犯(3/5),2例见血管包埋征;6例可见胰管扩张,4例可见胆总管扩张。结论胰腺腺鳞癌多为边界不清的实性肿块,周边呈环形强化,中央区域渐进性强化并常伴有血管侵犯及胰胆管扩张。

Objective To investigate the MR imaging features of pancreatic adenosquamous carcinoma(PASC),and get a better understanding of this disease.Methods MR images of 8 patients(both unenhanced and enhanced MR,n=5;only unenhanced MR,n=3)with pathologically proven PASC were retrospectively analyzed.Tumor location,shape,signal intensity,dynamic enhancement pattern,vessel involvement and dilatation of main pancreatic duct(MPD)and common bile duct(CBD)were evaluated.Results Four masses were located in the head or uncinated process of the pancreas and another four were in the pancreatic body.PASC usually showed ill-defined and predominantly solid masses(7/8).Only one tumor was predominantly cystic.Ring enhancement in the peripheral area was seen in 4 cases(4/5),while the central area of the tumor showed relatively poorer enhancement and showed progressive enhancement.Vessel invasion was seen in 3 masses,vessel encasement was seen in 2 cases.Upstream MPD dilatation was seen in 6 cases and CBD dilatation was seen in 4 cases.Conclusion PASC commonly manifests as an ill-defined,predominantly solid mass with peripheral ring enhancement,and may show vessel invasion,upstream MPD and CBD dilatation.