摘要目的 探讨胰腺实性假乳头状瘤的CT影像学特点,以提高该病术前的正确诊断率.方法 回顾性分析21例经手术、病理证实的胰腺实性假乳头状瘤的CT表现.结果 21例患者中青年女性(9～29岁)为19例.13例病灶位于胰头颈部,胰体、尾各有4例.肿块最大直径为3～15 cm,平均约7.5 cm.CT表现为胰腺单发类圆形囊实性肿块,18例有完整的包膜,3例与周围组织分界欠清,5例肿瘤出现包膜或中心散在钙化,仅1例出现胰管扩张(直径约5 mm),无1例出现胆管改变.增强后动脉期肿瘤包膜和实性部分轻中度强化,门脉期、延迟期明显强化;瘤内囊性部分不强化,包膜明显强化.结论 胰腺实性假乳头状瘤CT表现具有一定的特征性,综合临床及影像学表现,一般可做出较准确诊断.

abstractsObjective To investigate the CT imaging features of solid pseudopapillary tumor of the pancreas (SPTP) and to improve the preoperative diagnostic accuracy. Methods A retrospective analysis was performed on the CT manifestations of 21 cases of SPTP confirmed by pathology and surgery. Results In the 21 cases of SPTP, 19 were young and middle-aged female (range: 9～29 years old). The lesions were located in the pancreatic head and neck in 13 cases, and in the pancreatic body and tail in 4 cases each. The maximum diameter of tumor was 3 ～ 15 cm (mean 7.5cm). CT showed a single, round-like, cystic and solid mass in the pancreas. Eighteen cases had a complete capsule, and 3 cases had poorly defined margin with surrounding tissue. 5 cases of tumor were encapsulated or appeared scattered calcification in the center, only 1 case had pancreatic duct dilation (about 5mm in diameter), and no patient had bile duct changes. After enhanced scanning, the tumor capsule and the solid part were mildly to moderately enhanced during arterial phase, and they were significantly enhanced during portal venous phase and equilibrium phase. The cystic part was not enhanced, but the capsule was significantly enhanced. Conclusions CT manifestations of solid pseudopapillary tumor of the pancreas have certain characteristics, and when combined with clinical and imaging manifestations, accurate diagnosis generally can be made.