儿童胰母细胞瘤的CT与MRI诊断

目的 探讨儿童胰母细胞瘤的CT、MRI特征及临床表现，以提高对该病的认识。方法 选取术后病理证实为胰母细胞瘤患儿7例，采用CT或MRI增强扫描，分析其影像学特点。结果 7例均发生于胰头区，肿块大小1.0～7.5cm，平均约4.3 cm,CT表现为与胰腺密度相仿或低密度结节影，密度均匀或欠均匀、呈分叶状，2例囊变，1例钙化，增强扫描动脉期5例病灶表现为不均匀轻度强化，2例表现为均匀强化；2例MRI表现为边界清楚结节影，T₁WI呈低或中等信号，T₂WI呈等信号或等高信号，增强后不均匀强化，1例主胰管扩张，3例胆总管扩张。结论 儿童胰母细胞瘤作为罕见病，多发生于10岁以下儿童，具有胰头区低密度占位并增强后不均匀轻度强化等特点，偶合并胰胆管扩张可提高对该病的诊断。

CT and MRI diagnosis of pancreatoblastoma in children

Objective To analyze the imaging features of pancreatoblastoma in children and to summarize the clinical conditions,so as to improve the recognition of this disease.Methods 7 cases with pancreatoblastoma,which were proved by surgery and pathology,underwent CT enhancement or MRI enhancement,and the imaging characteristics were analyzed.Results 7 cases occurred in the head of pancreas,the size of the tumors ranged from 1.0 cm to 7.5 cm,with an average of 4.3 cm.CT performance showed low density nodular shadows or the density of pancreas approximately,uniform density or not uniform density of lobulated in shape.2 cases had prominent cystoid variation,1 case had calcificationn,5 cases had slight heterogeneous enhancement and 2 homogenous enhancement of scanning arterial lesions.2 cases of MR were characterized by nodular shadows clearly,MR showed low to intermediate signal intensity on T₁-weighted images and intermediate to heterogeneous high signal intensity on T₂-weighted images,which was homogeneous enhancement of a boundary nodular shadow.Dilatation of pancreatic main duct was found in 1 case,of which 3 cases were combined with bile duct dilatation.Conclusion Pancreatoblastoma is a rare disease,mostly occurred in children under 10 years old.It is characterized by low-density mass in the head of the pancreas heterogeneously enhanced in the tumor,and combined with cholangiopancreatography can improve the diagnosis of this disease.