胰腺内副脾的影像学诊断

Imaging diagnosis of intrapancreatic accessory spleen

目的探讨胰腺内副脾(IPAS)的影像学表现。方法选取5例IPAS患者的临床及影像学资料,分析其影像学特征及误诊原因。结果5例IPAS病灶均位于胰腺尾部,3例呈实质性肿块,2例伴表皮样囊肿形成。5例病灶实质性部分密度或信号与脾脏相似,1例实质性肿块IPAS动态增强MRI扫描各期病灶强化方式及程度均与脾脏相似;2例实质性肿块及2例伴表皮样囊肿形成,病灶实质性部分动态增强扫描动脉期均匀强化且强化程度高于胰腺,门静脉期均匀强化且与脾脏强化程度一致。结论准确诊断IPAS可避免因误诊而进行不必要的手术干预。

Objective To investigate the imaging features of intrapancreatic accessory spleen(IPAS)in order to improve the diagnostic accuracy.Methods Clinical and imaging data of 5 patients with IPAS were collected to analyze their imaging characteristics and misdiagnosis reasons.Results All IPAS lesions were located in the tail of the pancreas in 5 cases,3 cases were solid masses,and 2 cases were associated with epidermoid cyst formation.In 5 cases,the density or signal of the lesion was similar to that of the spleen,and in 1 case,the intensification method and degree of the lesion in each stage of IPAS dynamic enhanced MR scan were similar to that of the spleen.In 2 case of solid mass and 2 cases with epidermoid cyst,the solid part of the lesion was uniformly enhanced in the arterial phase and the enhancement degree was higher than that in the pancreas.In the portal vein phase,the enhancement degree was consistent with that in the spleen.Conclusion Understanding the imaging characteristics of IPAS and accurately diagnosing IPAS can avoid unnecessary surgical intervention due to misdiagnosis.