胰腺实性假乳头状瘤的CT和MR诊断

目的分析胰腺实性假乳头状瘤的多期增强扫描CT和MR表现特点。方法回顾性分析31例经手术和病理证实的胰腺实性假乳头状瘤的CT和MR表现。结果肿瘤位于胰头8例，胰颈5例，胰体5例，胰尾12例．范围广泛1例；肿瘤最大径16～135mm，平均55．5mm。25例为类圆形或卵圆形，6例不规则分叶状。肿瘤以实性为主8例，以囊性为主8例，囊实比例相近15例。动态增强扫描24例实性部分呈渐进性强化，6例呈持续强化，1例动脉期中度强化、门脉期及延迟期廓清，囊性部分无强化。30例肿瘤有包膜，增强后明显强化，瘤内有出血5例，瘤内见钙化9例．伴肝外胆管及胰管扩张1例，胰管扩张1例，肝脏转移1例。结论胰腺实性假乳头状瘤CT和MRI表现具有相对特征性，结合临床资料能做出明确诊断，并对手术方式的选择和预后评估有重要作用。

CT and MRI diagnosis of solid pseudopapillary tumor of the pancreas

Objective To analyze the imaging features of solid pseudopapillary tumor of the pancreas(SPTP) on CT and MRI with multiphase enhancement and assess their clinical significance suggestive.Methods The findings of CT and MR imaging in 31 cases with pathologically proved SPTP were reviewed.Results They were located at the head(n = 8),neck(n = 5),body(n = 5),tail(n = 12) of the pancreas.And 1 case’s range is extensive.Their shapes were round or oval(n = 25),and irregular or lobulated(n = 6).The long-axis diameter ranged from 16-135mm(mean 55.5 mm).8 tumor were predominantly composed of solid portions,8tumor were predominantly composed of cystic portions,and 15tumor were mainly composed of similar proportions of solid and cystic portions.After dynamic contrast-enhancement,the solid parts of the lesion showed progressive enhancement(n = 24),continuity enhancement(n = 6),and 1 case midrange enhancement on arterial phase,clearance in portal venous phase and delayed phase.And the cystic parts of the lesion showed no enhancement.30 cases were encapsulated and made more remarkable on post-contrast images.5 cases contained internal hemorrhage.Calcification was noted in 9 cases.Pancreatic duct broadening was caused by tumor in 1 case,and pancreatic duct broadening and common bile duct dilatation was caused by tumor in 1 case.And the hepatic metastasis was founded in 1case.Conclusion There are comparatively characteristic CT and MR imaging features of SPTP.The disease might be correctly diagnosed combined with clinical feature.It’s helpful to select operation mode and evaluate prognosis.