胰腺实性假乳头状瘤的CT和MRI征象及病理回顾

目的探讨胰腺实性假乳头状瘤(SPTP)的CT和MRI征象,提高对该病影像征象的认识。方法回顾性分析2008年至2014年间于我院经手术后病理确诊为胰腺实性假乳头状瘤的15例患者的CT及MRI图像,并与病理结果对照。结果肿瘤以囊性成分为主型5例,实性成分为主型3例,囊实性比例相间型7例。其中2例病灶可见出血,3例病灶可见钙化。CT平扫肿瘤实性部分CT值平均(37.56±9.53)Hu;增强动脉期平均(54.5±9.75)Hu;门脉期平均(72.0±17.1)Hu,呈渐进性强化。囊性部分平扫平均(24±12.52)Hu;增强扫描无强化。MRI上肿瘤实性成分T1WI呈等/稍低信号,T2WI呈等/稍高信号,增强扫描呈延迟强化趋势。囊性成分T1WI呈低信号,T2WI呈高信号,增强扫描无强化。肿瘤包膜在T1WI及T2WI上均呈低信号,增强扫描呈延迟强化。2例肿瘤内出血病灶在T1WI上可见环样、云絮样高信号,相应区域在T2WI上呈低信号。3例肿瘤内钙化在T1WI及T2WI上均呈低信号。结论胰腺实性假乳头状瘤的CT、MRI征象有一定的特征性,术前如能抓住该病的特征性影像表现,对其定性诊断有很大的帮助。

The Imaging Features and Pathological Analysis of Solid Pseudopapillary Tumors of Pancreas

Objective To explore the imaging characterize and to analysis the pathology organization of solid pseudopapillary tumors of pancreas.Methods Retrospective analysis of 15 cases diagnosed as solid pseudopapillary tumors of pancreas by pathology after surgery in patients with CT and MRI images.Results Tumors contained mostly cystic component in 5 cases and mostly solid components in 3cases,contained similar proportion of solid and cystic part in 7 cases.Tumor hemorrhage in 2 cases and tumor with calcification in 3 cases. CT scan solid part of the tumor CT value of the average is (37.56±9.53)Hu, enhanced arterial phase average (54.5±9.75)Hu, venous phase average (72.0±17.1)Hu,showed a gradual strengthening. CT scan Cystic part of the tumor CT value of the average is (24±12.52)Hu,enhanced scan without enhancement.Solid tumor components T1WI showed equal/lower signal, T2WI showed equal/higher signal, enhanced scan showed a trend of delayed enhancement. Cystic component T1WI showed low signal, T2WI showed high signal, enhanced scan without enhancement. Tumor capsule showed low signal on T1WI and T2WI, enhanced scan showed delayed enhancement. 2 cases of tumor hemorrhage lesions on T1WI visible ring-like, cloud-like high signal, Corresponding area on T2WI showed low signal.2 cases of Calcification within the tumor showed low signal on T1WI and T2WI.Conclusion There are certain characteristics of the The imaging features of solid pseudopapillary tumors of pancreas. There would be a great help to their diagnosis if they can catch the disease characteristic imaging findings preoperatively.