胰腺实性假乳头状瘤的影像表现

目的 探讨胰腺实性假乳头状瘤(SPTP)的影像学特征。方法 回顾性分析经手术病理证实的34例SPTP患者的CT和MR资料。结果 SPTP位于胰头部14例(14/34, 41.18%), 胰腺颈部及体部各4例(4/34, 11.76%), 胰尾部12例(12/34, 35.29%)。21例囊实性(21/34, 61.76%), 7例囊性为主(7/34, 20.59%), 6例实性为主(6/34, 17.65%)。CT平扫囊性部分呈低密度, 实性部分呈等低密度;MR平扫T1WI呈不均匀混杂信号, T2WI以高信号为主。增强扫描实性部分及包膜静脉期及平衡期强化, 囊性部分不强化。2例中心见点片状钙化, 6例边缘呈环状钙化;2例胰管扩张;3例十二指肠受压、2例左肾受压、4例脾脏及脾静脉受压、3例胃受压。结论 SPTP CT及MRI具有一定特征, 有助于提高术前诊断SPTP准确率。

Image characteristics of solid pseudopapillary tumor of the pancreas

Objective To evaluate the imaging characteristics of solid pseudopapillary tumor of the pancreas (SPTP). Methods CT and MR data of 34 patients with SPTP confirmed pathologically were retrospectively analyzed. Results There were 14 SPTP located in the head (14/34, 41.18%), 4 in the body (4/34, 11.76%), 4 in the neck (4/34, 11.76%), 12 cases in the tail of the pancreas (12/34, 35.29%). Twenty-one tumors contained both solid and cystic component (21/34, 61.76%), 7 cases were cystic (7/34, 20.59%) and 6 cases were solid (6/34, 17.65%). In CT plain scanning, cystic component showed low-density, solid component showed equal-density. In MR plain scanning, tumor showed mixed heterogeneous signal on T1WI and mainly hyperintense on T2WI. In enhancement scanning, solid and capsular showed enhancement in venous phase and balance phase, cystic showed no enhancement. Center point calcification were observed in 2 cases and rim calcification were observed in 6 cases. The pancreatic duct dilated in 2 cases. Duodenum and the surrounding structures in 3 cases, left kidney in 2 cases, the spleen and splenic vein in 4 cases and stomach in 2 cases were compressed. Conclusion SPTP has certain characteristics on CT and MRI, which is helpful for accurate preoperative diagnosis.