论文部分内容阅读
目的探讨胰腺实性假乳头状瘤的CT和MRI表现,加深对SPNP的影像及临床病理特点认识,提高影像诊断水平。方法回顾性分析四川省医学科学院四川省人民医院2010年1月至2015年12月期间经手术和病理学检查证实的7例胰腺实性假乳头状瘤的临床及影像资料。重点分析肿块的大小、位置、生长方式、形态、包膜、钙化、出血以及与正常胰腺及周围组织的关系,胆管、胰管扩张等情况,在CT及MR平扫及增强扫描的图像特点。结果 7例均为女性。平均年龄28.3岁,肿瘤平均直径为5.7 cm。1例肿瘤位于胰头部、1例位于胰尾部,5例位于胰体尾部。外生性肿瘤5例,内生性肿瘤2例。肿瘤边界规则5例,不规则2例。4例行CT平扫加增强扫描,均表现为囊实混合型肿块,平扫呈等或低密度,增强扫描动脉期实性部分及囊壁有轻度强化,门静脉期及延迟期呈持续强化且强化程度增加,但始终低于正常胰腺实质;囊性部分三期均未见强化。另3例行MRI平扫加增强,2例肿块内可见出血,其中1例位于胰腺头部,包膜不完整,与十二指肠粘连,压迫胆总管导致肝内外胆管及胰管扩张、胆囊增大。结论胰腺实性假乳头状瘤的CT和MRI影像学表现有一定特征,通过影像学及临床特点可在术前做出较为准确的诊断。
Objective To investigate the CT and MRI findings of solid pseudopapillary tumors of the pancreas, to deepen the understanding of the imaging and clinicopathological features of SPNP and to improve the imaging diagnosis. Methods The clinical and imaging data of 7 cases of solid pseudopapillary pancreatic tumors confirmed by surgery and pathology from January 2010 to December 2015 in Sichuan Provincial People’s Hospital of Sichuan Academy of Medical Sciences were retrospectively analyzed. Focus on the size, location, growth pattern, morphology, envelope, calcification, hemorrhage and the relationship with the normal pancreas and surrounding tissue, bile duct, pancreatic duct dilatation and other conditions, CT and MR plain scan and enhanced scan image features. Results 7 cases were female. The average age was 28.3 years and the mean tumor diameter was 5.7 cm. One tumor was located in the head of pancreas, one in the tail of the pancreas and five in the pancreas. 5 cases of exogenous tumors, 2 cases of endogenous tumors. Tumor border rules in 5 cases, irregular in 2 cases. 4 cases of CT scan and contrast-enhanced scan, showed cystic mixed solid mass, was equal to or low density scan, enhance the real part of the arterial phase and the wall scan mild enhancement, portal vein and the delay was continued to strengthen And increased the degree of enhancement, but always lower than the normal parenchyma; Cystic part of the three were not enhanced. The other three cases underwent MRI scan and contrast enhancement. Two cases showed hemorrhage in the tumor. One case was located in the head of the pancreas. The capsule was incomplete and adhered to the duodenum. Compression of the common bile duct resulted in the expansion of the extrahepatic bile duct and pancreatic duct. The gallbladder Increase. Conclusion The CT and MRI features of solid pseudopapillary tumors of the pancreas have certain features. The accurate diagnosis can be made preoperatively by imaging and clinical features.