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目的分析胰腺腺泡细胞癌(ACC)患者应用CT与核磁共振成像(MRI)诊断的效果。方法对14例经病理证实为胰腺ACC患者的影像学资料进行分析。结果病理表现中,8例患者病灶在胰尾部,其中3例未见包膜;3例病灶累及脾脏被膜;2例累及左侧胰腺被膜。5例患者病灶在胰头部,其中1例胰管、胆管均未扩张,病灶累及门静脉;4例病灶侵入下腔的静脉壁。1例患者病灶在胰头、胰尾部均可见。CT下病灶密度不均匀且低于周边胰腺。增强CT动脉期、门脉期动脉均强化不均匀,且密度低于周边胰腺。MRI表现中常规T1WI为均匀的低信号。常规T2WI呈不均匀的稍高信号。脂肪抑制T2WI为稍高信号,且呈信号不均匀,病灶内未见脂肪成分。结论胰腺ACC在CT、MRI中的有特征性的影像学表现,通过总结分析有助于提升临床诊断水平。
Objective To analyze the diagnostic value of CT and magnetic resonance imaging (MRI) in patients with pancreatic acinar cell carcinoma (ACC). Methods The imaging data of 14 patients with pathologically confirmed pancreatic adenocarcinoma were analyzed. Results The pathological findings showed that the lesions of 8 patients were in the tail of the pancreas, of which 3 cases had no capsule, 3 cases involved the splenic capsule, and 2 cases involved the left pancreas. Five patients had lesions in the head of the pancreas. One of them had no pancreatic duct and bile ducts, and the lesion involved the portal vein. Four lesions penetrated into the inferior vena cava wall. One patient showed lesions in the pancreas and tail of the pancreas. CT lesion density is uneven and lower than the surrounding pancreas. Enhanced CT arterial phase, arterial portal hypertension were uneven, and the density lower than the surrounding pancreas. Conventional T1WI in MRI performance is a uniform low signal. Conventional T2WI showed a slightly higher signal non-uniform. Fat-suppressed T2WI is a slightly higher signal, and the signal was uneven, no fatty components within the lesion. Conclusion Pancreas ACC has characteristic imaging findings in CT and MRI. It is helpful to improve the clinical diagnosis by analyzing the results.