胰腺实性假乳头状瘤的MSCT诊断价值

发布时间：2018-12-28 20:38

【摘要】：目的研究胰腺实性假乳头状瘤(solid-pseudopapillary tumors of the pancreas,SPTP)的多层螺旋CT(multislice spiral CT,MSCT)表现,探讨MSCT图像后处理技术在显示SPTP瘤体与瘤周血管之间的关系,以及瘤体与周围组织间关系上的临床应用价值。方法回顾性分析经手术病理证实的34例SPTP影像学资料,包括CT表现,肿瘤与周围组织、邻近血管关系。结果 34例患者均为单发肿瘤,发生于胰头部16例(47.1%)、颈部2例(5.9%)、头颈部1例(2.9%)、体部5例(14.7%)、尾部4例(11.8%)、体尾部4例(11.8%)、钩突部2例(5.9%)。15例实性(44.1%),7例囊性(20.6%),12例为囊实性(35.3%)。34例中除1例完全钙化者无强化外,余33例病灶表现为包膜、实性部分或分隔持续强化,部分病灶内实性部分表现为云絮状不均质强化。MSCT后处理技术显示6例其病灶与邻近血管粘连、浸润,1例病灶与邻近组织器官粘连、分界不清,1例病灶包膜不完整,术前MSCT诊断与术中、术后病理相符。结论 MSCT检查对SPTP术前能做出正确诊断,MSCT后处理技术可清楚显示肿瘤与瘤周血管、组织之间的关系,对肿瘤可切除性评估具有较高的临床指导价值。
[Abstract]:Objective to study the multilayer spiral CT (multislice spiral CT,MSCT findings of solid pseudopapillary tumors of the pancreas (solid-pseudopapillary tumors of the pancreas,SPTP) and to explore the relationship between SPTP tumors and surrounding vessels by post-processing MSCT images. And the clinical application value of the relationship between tumor and surrounding tissues. Methods the imaging data of 34 cases of SPTP confirmed by operation and pathology were retrospectively analyzed, including CT findings, tumor and peripheral tissues, and the relationship between adjacent blood vessels. Results all 34 cases were single tumors, including 16 cases of pancreatic head (47.1%), 2 cases of neck (5.9%), 1 case of head and neck (2.9%), 5 cases of body (14.7%), 4 cases of tail (11.8%). There were 4 cases (11.8%) in the body and tail, 2 cases (5.9%) in the uncinate process, 15 cases (44.1%) in the solid, 7 cases (20.6%) in the cystic, 12 cases (35.3%) in the cyst. In the remaining 33 cases, the lesions presented as capsule, solid partial or septal continuous enhancement, and partial consolidation as cloud flocculent uneven enhancement. MSCT postprocessing technique showed that 6 cases had adhesion and infiltration with adjacent blood vessels. 1 case had adhesion with adjacent tissues and organs, the boundary was not clear, and 1 case had incomplete capsule. The diagnosis of MSCT before operation was consistent with that of intraoperative and postoperative pathology. Conclusion MSCT can make a correct diagnosis of SPTP before operation. MSCT post-processing technique can clearly show the relationship between tumor and peripheral blood vessels and tissues. It has a high clinical guiding value for the evaluation of tumor resectability.
【作者单位】：江苏省宿迁市人民医院放射科;上海交通大学附属瑞金医院放射科;
【基金】：上海市科学技术委员会科研项目(课题编号:13NM1401505)
【分类号】：R735.9;R730.44

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