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 胰腺实性假乳头状瘤的CT和MRI表现
来源：中国论文下载中心    [ 06-07-04 16:41:00 ]    作者：赵心明，周纯武，苏勤   

摘要】  目的  探讨胰腺实性假乳头状瘤的CT和MRI表现。方法  回顾性分析经手术病理证实的8例胰腺实性假乳头状瘤的影像资料。其中，CT扫描7例，MRI扫描2例。结果  肿瘤最长径3.5～15cm，平均9.5cm。2例肿瘤以囊性成分为主，1例实、囊成分比例相仿；5例以实性成分为主。在囊实性交界部分，实质与囊性部分呈片状相间分布。3例囊性成分内可见纤维分隔。CT增强扫描门静脉期肿瘤强化略高于动脉期，但其强化程度均低于正常胰腺组织。5例有钙化。MRI 2例在T1WI、T2WI上呈混杂信号，实性成分在T1WI呈中低信号，T2WI呈中高信号，增强扫描呈不均性的中高强化。结论  胰腺实性假乳头状瘤的CT、MRI表现有一定特征性，结合临床特征并注意与无功能胰岛细胞瘤、黏液性囊性瘤或癌等鉴别可在术前做出正确诊断。
   
    【关键词】  胰腺肿瘤； 体层摄影术；X线计算机；磁共振成像
        
    【Abstract】  Objective  To study the CT and MRI features of solid-pseudopapillary tumors of pancreas(SPTP).Methods  Imaging findings of 8 patients with histopathologically proven SPTP were retrospectively analyzed. Of 8 cases，CT was performed in 7 patients，and MRI in 2 patients.Results  The mean diameter of these tumors was 9.5cm(3.5～15cm). Two tumors were predominantly composed of cystic portions，1 tumor was composed of similar proportions of solid and cystic portions，and 5 tumors were mainly composed of solid portions. The interface of solid and cystic component is interweaved. Fibrous septa was seen in cystic area in 3 cases. Enhancement of solid portions was slight higher in portal venous phase than arterial phase on post-contrast CT，but was lower in both phase than normal pancreas. Calcification was seen in 5 cases on CT. Lesions showed mixed signal intensities on T1WI and T2WI，and solid portions of mass showed moderate hypointensity on T1WI，and moderate hyperintensity on T2WI，and heterogeneous enhancement enhanced T1WI MRI in 2 cases.Conclusion  There are some characteristics in CT and MRI manifestation of SPTP. The disease might be correctly diagnosed combined with the clinical feature，and should be differentiated from nonfunctioning islet cell tumor，mucinous cystadenoma or cystcarcinoma of the pancreas，etc.
   
    【Key words】  pancreatic neoplasm；tomography；X-ray computed；magnetic resonance imaging
   
    胰腺实性假乳头状瘤(solid-pseudopapillary tumors of pancreas，SPTP)是少见的良性或低度恶性肿瘤或具有恶性潜能的良性肿瘤，约占胰腺外分泌肿瘤的1%~2%［1］。胰腺实性假乳头状瘤预后明显好于胰腺癌，多数患者肿瘤切除术后可获得长期生存［2］。提高对本病的认识对于指导治疗、判断预后等具有十分重要的意义。目前文献对其报道较少，对其影像表现尚无定论，而其影像表现与胰腺其他良性或低度恶性肿瘤有很多类似的表现，常常误诊。笔者总结我院手术病理证实的8例SPTP的影像表现，以提高对该病影像表现的认识。
   
    1  资料与方法
   
    1.1  一般资料  回顾性分析2003年5月～2005年3月经手术病理证实的SPTP 8例，均为女性，年龄14～50岁，中位年龄25岁。肿瘤标记物检查，血液CEA、CA199、CA242均在正常值范围内。无特异的临床症状。
   
    1.2  方法
   
    1.2.1  CT扫描（7例）  采用GE Light Speed Ultra螺旋CT扫描仪，扫描条件为120kV，230mA，扫描时间0.8s，层厚5mm连续，螺距0.875∶1，矩阵512×512，重建层厚1