胰腺实性假乳头状瘤的CT诊断价值

目的探讨CT对胰腺实性假乳头状瘤(SPTP)的诊断价值。方法进行回顾性分析9例经病理证实的SPTP的CT检查资料,所有病例均行CT平扫及动态增强扫描。结果①肿瘤位于胰头部4例,尾部3例,体、颈部2例。7例呈圆形,2例呈分叶状。瘤体直径2.7~12.6cm,平均4.9cm。②CT平扫肿瘤实性部分8例呈稍低密度,1例呈等密度,囊性部分呈低密度;4例可见钙化;增强动脉期肿瘤实性部分呈轻度强化7例,中度强化2例;门脉期7例实性部分呈渐进填充强化,2例较动脉期强化无明显变化;延迟期肿瘤呈不均匀低密度。包膜动脉期轻或中度强化,门脉期持续强化,延迟期呈相对高密度。2例位于胰头颈体部肿瘤不同程度推压邻近血管;1例位于胰尾推挤脾门;3例胰头区肿块推压十二指肠。结论 SPTP的CT表现具有一定的特征,CT检查能准确显示肿瘤的部位、大小及病理特征,做出正确诊断,同时还能准确显示包膜、肿瘤与胰腺及邻近结构解剖关系,具有重要临床应用价值。

The Diagnosis Value of CT for Solid-pseudopapiUary Tumor of the Pancreas

Objective To investigate CT value in diagnosing solid-pseudopapillary tumor of the pancreas （SPTP）. Methods CT finding of 9 cases with SPTP proved by pathology＇ were analyzed retrospectively. Plain and dynamic enhanced CT scanning was performed in all patients. Results （1） 4 cases of the tumors located in the head of the pancreas, 3 cases located in the tail of the pancreas, 2cases located in the body and neck of the pancreas. 7cases were round,2 cases were lobulated. Tumor diameters were 2.7-12.6cm, average 4.9cm. （2）CT scan showed that solid tumor were slightly low-density of 8 cases, equal density of 1 case showed, low density of the cystic part; 4 cases showed calcification. Enhance of arterial phase the solid part tumor showed mild enhancement of 7 cases, 2 cases of moderately enhanced; 7 cases the solid part gradual fillied strengthening at portal venous phase, 2 cases of arterial phase reinforced no significant change; all showed heterogeneous low-density at delay phase. All the capsules enhanced mild or moderately at arterial phase, continued to strengthen at portal phase, showed relatively high density at delay period. 2 cases pushed the adjacent vascular tumor varying degrees; 1 case in the tail of the pancreas pushed the splenic hilum; 3 cases located in the head of pancreatic pushed the duodenum. Conclusion CT findings of SPTP had certain characteristics, CT could not only accurately display the location, the size of genotyping and pathological features of the tumor, but also could accurately display the capsule is the anatomical relationship of the tumor and pancreas, adjacent structures, and had great clinic value.