5例胰腺内副脾表皮样囊肿影像学表现分析

发布时间：2018-04-07 17:35

本文选题：胰腺　切入点：胰腺内副脾　出处：《临床放射学杂志》2017年04期

【摘要】：目的回顾性分析胰腺内副脾表皮样囊肿(ECIPAS)的临床及影像学表现,提高对该病的认识及诊断水平。方法搜集经手术病理证实的5例胰腺内副脾表皮样囊肿的临床及影像学资料,分析其临床特征、CT及MRI表现,影像学特征包括:位置、大小、钙化、囊的特征、密度(信号)及强化特点。结果 5例患者均为女性,均为体检偶然发现,3例CA19-9升高。行CT检查者4例,行MRI检查者3例。5例均发生于胰尾内,其中1例与脾脏分界不清;病灶长径2.0~5.5 cm,平均为3.4 cm;3例表现为多囊,1例为单囊,1例呈囊实性;3例边缘显示为"厚壁"的实性成分,平扫密度/信号、多期动态增强表现与脾脏类似,给出了提示性诊断;2例壁菲薄,无明显周围副脾样组织,其中1例内部见部分实性成分,增强扫描轻度强化,术前分别诊断为胰腺囊腺瘤及实性假乳头状瘤。结论ECIPAS是一种非常少见的病变,发生在胰尾部的囊性或囊实性病变,应考虑到ECIPAS的可能,尤其在动态增强检查时发现类似于脾脏改变的囊壁。然而一些缺乏囊壁或囊壁菲薄的病变术前诊断困难,需要病理确诊。
[Abstract]:Objective to analyze retrospectively the clinical and imaging features of epidermoid cyst of the accessory spleen of pancreas (ECIPASA) and to improve the understanding and diagnosis of the disease.Methods the clinical and imaging data of 5 cases of epidermoid cyst of the accessory spleen of pancreas proved by operation and pathology were collected. The clinical features of CT and MRI were analyzed. The imaging features included location, size, calcification and cyst.Density (signal) and enhancement characteristics.Results all 5 cases were female, and 3 cases of CA19-9 were found to be elevated by physical examination.Ct examination was performed in 4 cases, MRI in 3 cases in 5 cases occurred in the pancreatic tail, in which 1 case was indistinct from the splenic boundary.The mean length of lesion was 2. 0 ~ 5. 5 cm, with an average of 3. 4 cm, 3 cases with polycystic lesion, 1 case with single cyst, 1 case with solid and solid cyst, 3 cases with "thick wall" solid component, plain scan density / signal, and multi-phase dynamic contrast enhanced appearance was similar to that of spleen.Two cases with thin wall and no peripheral paripplegic tissue were presented as indicative diagnosis. In one case, partial solid components were found in the inner part, enhanced slightly, and were diagnosed as pancreatic cystadenoma and solid pseudopapillary tumor before operation, respectively.Conclusion ECIPAS is a rare disease. Cystic or solid lesions occurring in the tail of pancreas should be taken into account, especially the cystic wall similar to splenic changes found during dynamic contrast enhancement.However, the diagnosis of some lesions lacking or thin cystic wall is difficult before operation and needs to be confirmed by pathology.
【作者单位】：浙江大学医学院附属邵逸夫医院放射科;
【分类号】：R576;R816.5;R445.2

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