CT、MRI诊断胰腺实性假乳头状瘤

目的探讨CT、MRI诊断胰腺实性假乳头状瘤（SPTP）的临床价值。方法回顾性分析19例经病理证实的SPTP患者的CT及MRI资料。结果①肿瘤位于胰头部8例，尾部5例，体、颈部6例；实性成分为主型9例，囊实成分相间型7例，囊性成分为主型3例；②CT平扫肿瘤实性部分15例呈稍低密度，4例呈等密度，囊性部分呈低密度。增强动脉期肿瘤实性部分呈轻度强化12例，中度强化7例；门静脉期14例呈渐进填充强化，5例无明显变化；延迟期呈不均匀低密度。包膜14例完整，5例不完整，延迟期呈持续强化的高密度；③肿瘤实性部分T1wI呈稍低信号，T2WI呈等或稍高信号；囊性部分7例T1wI呈低信号，T2wI高信号，3例T1wI呈高信号，T2wI呈高低混杂信号。抑脂T2wI4例见环状低信号包膜。动态增强扫描与增强CT表现相仿，动脉期肿瘤以轻度强化为主，门静脉期及延迟期10例肿瘤实性部分均呈持续填充强化，延迟期包膜均明显强化、呈相对高信号。结论SPTP的CT和MRI表现具有一定特征，对术前制定手术方案、术后远期评估具有重要价值。

CT and MRI in diagnosis of solid-pseudopapillary tumor of pancreas

Objective To investigate clinical value of CT and MRI in diagnosis of solid-pseudopapillary tumor of pancreas （SPTP）. Methods CT and MRI findings of 19 cases with SPTP proved by pathology were analyzed retrospectively. Results @Eight tumors located in the head, 5 located in the tail, while 6 located in the body and neck of the pancreas. Tumors in 9 cases were predominantly solid, in 3 were predominantly cystic, while in 7 cases were alternately solid and cystic. QCT showed that solid tumors were slightly low-density in 15 cases and equal density in 4 cases, and the cystic part were low density. The solid part of tumors mildly enhanced in 12 cases, moderately enhanced in 7 cases at arterial phase. At portal venous phase, the solid part of tumors showed gradually filling enhancement in 14 cases, showed no significant changed compared with arterial phase in 5 cases. All tumors showed heterogeneous low-density at delayed phase. All the capsules, 14 were complete and 5 were not, enhanced and showed relatively high density at delay phase. （~Solid part of tumor showed slightly lower signal on T1WI and equal or slightly higher signal on T2WI. The cystic portion of tumors in 7 cases showed low signal, while in 3 cases showed high signal on TIWI, in 7 cases showed high signal and in 3 cases showed heterogeneous level of mixed-signal on T2WI. Cyclic low signal of capsules at the edge of tumors were found on fat sup- pression T2WI. The enhancement patterns of tumors during dynamic contrast-enhanced MRI were similar to CT. The tumors enhanced mildly at artery phase, the solid part of tumor in 10 cases showed continuous enhancement at portal ve- nous phase, and capsules strengthened significantly to relatively high signal at delayed phase. Conclusion CT and MRI findings of SPTP have certain characteristics, which have great value for preoperative program development and long-term postoperative assessment.