儿童胰腺实性假乳头状瘤与胰腺母细胞瘤的MSCT鉴别诊断

Differentiation of Solid Psuedopapillary Neoplasm of the Pancreas and Pancreatoblastoma in Children with Multi⁃Slice Spiral CT and MRI

目的:分析儿童胰腺实性假乳头状瘤(SPN)与胰腺母细胞瘤(PBL)的多层螺旋CT(MSCT)表现,探讨MSCT对两者的鉴别诊断价值。方法:回顾性分析我院2009年4月—2021年4月术后经病理确诊的11例SPN及11例PBL患儿的临床及MSCT资料。所有患者术前行腹部CT平扫和增强扫描。采用独立样本t检验对2组患者的年龄、病灶最大径、强化幅度进行比较。采用Fisher确切概率法对2组病灶的位置、形态、边界、密度、钙化、出血、胰胆管扩张、邻近组织侵犯及远处转移、并发门脉高压进行比较。结果:SPN组患者发病年龄[(125±24.3)个月]较PBL组[(60.8±49.4)个月]大。2组间的边界、有无钙化、强化幅度、有无邻近组织受侵及远处转移的差异均有统计学意义(P<0.05)。SPN组边界较PBL组清晰,PBL组钙化较SPN组多见,PBL组强化程度较SPN组高,PBL组邻近组织受侵及远处转移较SPN组多见。2组间肿瘤的位置、最大径、形态、密度、出血、胰胆管扩张、是否并发门脉高压的差异均无统计学意义。结论:MSCT检查对SPN及PBL具有鉴别诊断价值。

Purpose:To analyze the manifestations of solid pseudopapillary neoplasm of the pancreas(SPN)and pancreatoblastoma(PBL)in children on multi-slice spiral CT,and to explore the differential diagnostic values of the CT technique.Methods:Eleven patients with SPN and 11 patients with PBL were collected from April 2009 to April 2021.All patients underwent abdominal plain and enhanced CT scan before operation.Independent-sample t test was used to compare the differences in patient's age,long diameter and enhancement magnitude between the two groups.Fisher exact test was used to compare the differences in location,morphology,boundary,density,calcification,hemorrhage,catheter expansion,local invasion or distant metastases,complicated or not complicated portal hypertension between the two groups.Results:The age of the SPN group[(125±24.3)months)]was significantly higher than the PBL group[(60.8±49.4)months)].There were statistical significances in the boundaries,calcification,enhancement magnitude,presence or absence of lymphonodus metastasis between the two groups(all P<0.05).The boundary of the SPN group was clearer than the PBL group.The number of calcified tumors in the SPN group was less than the PBL group.The enhancement magnitude in PBL group was higher than the SPN group.The lymphonodus metastasis occurred more often in the PBL group.There were no statistical significances in the location,long diameter,morphology,density,hemorrhage,presence or absence of catheter expansion and portal hypertension between the two groups.Conclusion:Multi-slice spiral CT has diagnostic value for differentiating SPN and PBL.