胰腺实性假乳头状瘤:MDCT诊断及鉴别

目的 探讨胰腺实性假乳头状瘤的多排螺旋CT(multi-detector computer tomography,MDCT)诊断价值.方法 回顾性分析11例经手术病理证实的胰腺实性假乳头状瘤的临床资料及MDCT表现.结果 11例临床多表现为上腹部胀痛不适,所有病例均无黄疸.CT表现为胰腺单发囊实性类圆形肿块,最大直径约5.5～13.6 cm,平均8.6 cm;肿瘤位于胰头部3例,胰体部2例,胰尾部6例.平扫肿瘤呈不均匀的较低密度,边界较清,3例肿块内可见钙化;动态增强后肿瘤实性成分呈不均匀的轻至中度进行性强化,弱于正常胰腺组织强化,囊变坏死区无强化,10例见较完整包膜,7例可见肿瘤与胰腺间呈“喇叭口”样界面.所有病例均无胆管及胰管扩张,未见腹腔及腹膜后肿大淋巴结.结论 胰腺实性假乳头状瘤多见于较年轻女性,好发于胰头、尾部,MDCT对其有较大诊断价值.

Solid pseudopapillary tumor of pancreas diagnosed with MDCT

Objective To assess the diagnostic value of multi-detector computed tomography （MDCT） for solid pseudopapillary tumor of the pancreas （SPTP）. Methods The MDCT findings and clinical data of 11 patients with SPTP confirmed by surgery and pathology were retrospectively analyzed. Results All patients had abdominal pain, and none had jaundice. All 11 cases showed single solid-cystic masses of pancreas with oval shapes on CT; the maximal diameter was 5.5 - 13.6 cm with an average of 8.6 cm. Three lesions were located in the head of pancreas,2 in the body of pancreas and 6 in the tail of pancreas. All tumors showed asymmetrical low density on plain CT scan with clear boundary, and calcification was observed in 3 cases. On dynamic enhancement scan, the solid tissue of all tumors showed slightly to moderately continuous asymmetrical enhancement, but were fainter than the normal tissue of pancreas. Rounded envelope was observed in 10 cases and ＂horn sign＂ between tumors and normal pancreatic tissue was observed in 7 cases. There was no associated dilatation of the common bile or pancreatic duet, and the enlargement of lymph nodes was not found in all cases. Conclusion MDCT is of value in the diagnosis of＂ solid pseudopapillary tumor of pancreas.