多普勒超声与多层螺旋CT在诊断鉴别胰腺实性假乳头状瘤中的应用研究

目的探讨并比较多普勒超声与多层螺旋CT在诊断鉴别胰腺实性假乳头状瘤(SPTP)中的应用价值。方法回顾性分析2012年3月-2016年3月经手术确诊的26例SPTP患者超声和CT影像学资料,分析超声和CT影像学特征,并与手术病理对照。结果超声表现为22例包膜完整,清晰边界,6例可见钙化组织;囊实性成分为主,实性部分为均匀低回声,囊性部分为低或无等回声区;多数CDFI显示回声区内有点状血流信号。CT平扫为低密度,22例包膜完整,10例有点片状或环状钙化组织,囊实性成分为主,实性部分可见乳头样结构,静脉期肿瘤实质部分明显强化,门脉期、延迟期进一步强化,呈渐进性特点,但仍低于正常胰腺实质部分;囊性部分分散于实性部分中,增强扫描未见明显强化。共同影像学特征为均未见胰胆管扩张、淋巴结转移等征象。CT诊断准确率为84.62%高于超声的57.69%(P0.05)。结论 SPTP的超声、CT影像学均具有特征性,可结合临床,与其他疾病进行鉴别诊断,且CT的术前诊断SPTP准确率高于超声。

Application of Doppler Ultrasonography and Multi-slice Spiral CT in Differential Diagnosis of Solid Pseudopapillary Tumor of Pancreas

Objective To explore and compare the value of Doppler ultrasonography and multi-slice spiral CT in the differential diagnosis of solid pseudopapillary tumor of pancreas (SPTP).Methods The ultrasonic and CT findings of 26 patients with SPTP diagnosed in our hospital from March 2012 to Match 2016 were retrospectively analyzed. All findings were analyzed and compared with the results of operation and pathology. Results The ultrasonic findings showed 22 cases with complete capsule and clear boundaries, and 6 cases with calcified tissues. The cystic solid component was the main part, and the solid part showed homogeneous low echo while the cystic part showed low or no echo area. Most CDFI showed punctiform blood flow signal in the echo area. CT scan was low density, and there were 22 cases with complete capsule and 10 cases with patchy or ring calcified tissues. The cystic components were the majority, solid part showed papillary structure. In venous phase, tumor parenchyma showed obvious enhancement, in portal venous phase and delayed phase, it showed further enhancement, with progressive features, which was still lower than the solid parts of normal pancreas. The cystic part was dispersed in the solid part, and no obvious enhancement was observed. There were no signs of pancreaticobiliary duct dilatation and lymph node metastasis. The diagnostic accuracy rate of CT (84.62%) was higher than that of ultrasound (P<0.05). Conclusion The ultrasonic and CT imaging of SPTP are characteristic, which can be combined with clinic for differential diagnosis of other diseases. The accuracy rate of preoperative diagnosis of CT is higher than ultrasonography.