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目的探讨胰腺实性假乳头状瘤的影像学表现,以提高对此类疾病的影像学诊断认识。方法回顾性分析我院2010~2014年间经手术病理证实的12例胰腺实性假乳头状瘤患者的临床资料、CT影像表现,并将影像学表现与手术病理结果对照。结果 12例均为单发病灶。肿瘤体积较大,最大径为1.5~12cm,平均5.2cm。肿瘤位于胰头5例,胰颈3例,胰体2例,胰尾2例。术前CT检查6例可见完整包膜,3例可见不完整包膜,3例未见到包膜。12例患者中3例肿块边缘见点线状钙化,3例肿块中央见条片状钙化,1例肿块中央及边缘均见钙化,5例肿块内未见钙化。平扫主要表现为圆形或分叶状囊实性肿块,增强后实性部分动脉期轻度强化,延迟扫描呈渐进性强化。10例瘤体内出现乳头状或间隔状强化,7例伴有胰管轻度扩张。结论 CT扫描尤其是增强扫描对SPTP确定诊断有重要价值。能够为临床术前诊断及手术方案的选择提供必要的帮助。
Objective To investigate the imaging findings of solid pseudopapillary tumor of pancreas in order to improve the understanding of imaging diagnosis of such diseases. Methods The clinical data and CT images of 12 patients with solid pseudopapillary tumor of the pancreas confirmed by surgery and pathology in our hospital from 2010 to 2014 were analyzed retrospectively. The imaging findings were compared with those of surgical pathology. Results 12 cases were single lesions. Tumor larger, the largest diameter of 1.5 ~ 12cm, an average of 5.2cm. The tumor was located in 5 cases of pancreatic head, pancreatic neck in 3 cases, pancreatic body in 2 cases, pancreatic tail in 2 cases. Preoperative CT examination in 6 cases showed complete capsule, 3 cases can be seen incomplete capsule, 3 cases did not see the capsule. Three of the 12 patients showed linear calcification at the edge of the tumor, three were calcified at the center of the tumor, calcification was found in one of the tumors at the center and at the periphery, and no calcification was found in the five tumors. Plain main manifestations of round or lobulated cystic mass, enhancement of the real part of the arterial phase mild enhancement, delayed scan was progressive enhancement. Ten cases of tumor appeared papillary or septal enhancement, 7 cases with pancreatic duct mild dilatation. Conclusion CT scan, especially enhanced scan, is of great value in the diagnosis of SPTP. Can provide the necessary help for the clinical preoperative diagnosis and choice of surgical plan.