超声、CT及MRI在胰腺实性假乳头状瘤诊断中的价值

目的探讨胰腺实性假乳头状瘤的超声US、CT及MRI表现,旨在提高对实性假乳头状瘤的认识,提高影像诊断准确率。方法回顾性分析2003年2月-2013年8月12例经手术病理证实的SPTP患者的US、CT、MRI特征及临床资料。结果 12例声像图呈实性、囊性或囊实混合性回声,CDFI多见点状血流;CT表现8例见钙化,依据肿瘤内实性和囊性成分比例不同,动脉期轻至中度强化,门脉期及延迟期呈渐进性强化,病灶增强扫描各期强化强化程度始终低于正常胰腺实质;MRI平扫囊性成分病灶在T1WI呈明显低信号,T2WI呈明显高信号;病变内实性成分T1WI呈低信号,T2WI等或略高信号;DWI呈高信号,增强扫描强化模式与CT强化模式相仿。结论 SPTP临床表现无特异性,好发于年轻女性,术前诊断主要依赖US、CT、MRI检查。影像学检查能够明确病变位置、大小及周围情况,为临床制定合理的手术方案提供更准确的信息,改善患者预后。

The value of ultrasound,CT and MRI in the diagnosis of solid pseudo papillary tumor of the pancreas

Objective To investigate the ultrasound（US）,CT and MRI features of pancreatic solid pseudo papillary tumor（SPTP）,so as to enhance the knowledge of solid pseudo papillary tumor,and to improve the accuracy of imaging diagnosis.Methods The CT,MRI features and clinical data of 12 cases of SPTP proved by operation and pathology from February 2003 to August 2013 were analyzed retrospectively.Results 11 patients in this group were female,with mean age 26.5years.The clinical symptoms and laboratory examination were no specific.Calcification was seen in 8cases.US showed solid,cystic or mixed echo,CDFI showed dotted blood flow;CT manifestations of SPTP depended on different proportion of solid and cystic components within the tumor on plain scanning.Mild to moderate enhancement were seen during the arterial phase,portal venous phase and delayed phase showed progressive enhancement,and always lower than normal pancreatic parenchyma;On MRI plain scan,most lesions manifested as obviously low signal on T1 WI,and obviously high signal on T2WI;solid components showed up as low signal on T1 WI,isointense or slightly higher signal on T2WI;DWI mostly showed high signal,and enhancement pattern was similar to CT.Conclusion SPTP has no specific clinical manifestations,and usually occurs in the young female.Preoperative diagnosis relies mainly on US,CT,MRI examination.Imaging examination can indicate the location,size and the surrounding situation of lesions,provide much more accurate information for clinician,and improve the prognosis of patients.