儿童胰腺实性假乳头状瘤多排螺旋CT表现

目的:探讨儿童胰腺实性假乳头状瘤（SPTP）的多排螺旋CT（MDCT）表现。 方法:回顾性分析经手术病理证实为SPTP的10例患儿临床及MDCT资料，分析总结其特征表现。 结果:10例患儿均为女性，SPTP均为单发病灶，位于胰腺头颈部3例，胰腺体尾部7例。肿瘤最大径为2.5~13.8 cm，平均值为5.94 cm。8例呈类圆形，2例呈分叶状。10例均边界清晰，8例有完整包膜。平扫1例肿瘤呈均匀低密度，增强无明显强化；其余9例呈囊实性，8例以实性为主，1例囊实性比例相当，其中1例可见包膜下弧形钙化，实性成分动脉期呈轻度强化，强化程度低于正常胰腺组织，门脉期呈渐进性不均匀强化，囊性成分无强化。1例肿瘤出现肝内胆管和主胰管轻度扩张，1例出现主胰管轻度扩张。所有肿瘤均未见肝脏及淋巴结转移。 结论:儿童SPTP好发于女性，其CT表现具有一定的特征性，对诊断和鉴别诊断具有一定意义。

Multidetector computed tomography features of solid pseudopapillary tumor of pancreas in children

Abstract: Objective To investigate multidetector computed tomography (MDCT) features of solid pseudopapillary tumor of the pancreas (SPTP) in pediatric patients. Methods Clinical data and MDCT findings of 10 pediatric patients with SPTP confirmed by surgery and pathology were retrospectively reviewed, and then the MDCT features were summarized. Results All the patients were female, and all the cases were of single lesion. Among the tumors, 3 located at the pancreatic head and neck, and the other 7 at the pancreatic body and tail. The maximum diameters of tumors were 2.5-13.8 cm, with an average of 5.94 cm. Eight tumors were round-like and 2 were lobulated. All tumors were well-circumscribed and 8 tumors had complete capsules. On CT images, 1 tumor showed homogeneous low density without enhancement, and the other 9 tumors consisted of solid and cystic component, with 8 cases containing mostly solid components and 1 case containing similar proportion of solid and cystic components. Subcapsular calcification was only found in 1 case. After contrast-enhanced scan, the solid components presented slight enhancement in the arterial phase, with an enhancement lower than normal pancreas, and progressive heterogeneous enhancement in the portal venous phase. The cystic components showed no enhancement. Mild dilatation was observed at bile duct and pancreatic duct in 1 case, and only pancreatic duct dilatation was found in another case. No patients developed liver or lymph nodes metastasis. Conclusion Pediatric SPTP often occurs in female patients. The characteristic CT features of SPTP play an important role in the diagnosis and differential diagnosis.