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[胰腺实性假乳头状瘤的诊断及螺旋CT后处理在手术中的价值]

[Diagnosis of solid-pseudopapillary tumor of the pancreas and the value of post-processing in the surgery by spiral CT].

作者信息

Jiang Bao-Dong, Ma Xiang-Xing, Wang Qing, Wang Qian, Fu Bin, Yu Fu-Hua

机构信息

Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2009 Apr 21;89(15):1060-3.

Abstract

OBJECTIVE

To study the CT manifestations of the solid-pseudopapillary tumor of the pancreas (SPTP) and to explore the value of post-processing in the surgery.

METHODS

Clinical and CT features of 14 patients with SPTP proved pathologically were retrospectively analyzed.

RESULTS

(1) 13 tumors were composed of different proportions of solid and cystic parts and 1 tumor was composed of solid part only. The solid portions demonstrated slight enhancement in the arterial phase and marked enhancement in the portal venous phase on post-contrast CT. The cystic portions appeared hypo-attenuation on both pre- and post-contrast CT images. Tumors were encapsulated and the capsule enhanced markedly with well-defined margins on post-contrast images. (2) Dilatation of the common bile duct or pancreatic duct wasn't seen in all of the cases and 1 case with the right adrenal ganglioneuroma. (3) 5 tumors located in the head of the pancreas, 3 of which with the superior mesenteric vein compression and displacement, in 2 cases the vessels were partially encapsulated by tumor. 6 tumors located in the tail of the pancreas, 3 of them with splenic hilum compression and multiple splenic vein tortuosity and dilatation, the veins drained into superior mesenteric vein anteriorly and posteriorly of the tumor. Splenic vein compression and posterior displacement occurred in 2 cases. In one case, there was no clear margin between the tumor and the splenic hilum.

CONCLUSION

The SPTP has characteristic CT findings and correct diagnosis could be made by combining clinical features. The relationship of the lesions and surrounding structures could be revealed by the post-processing and was helpful for the operation.

摘要

目的

研究胰腺实性假乳头状瘤(SPTP)的CT表现,探讨后处理技术在手术中的应用价值。

方法

回顾性分析14例经病理证实的SPTP患者的临床及CT特征。

结果

(1)13个肿瘤由不同比例的实性和囊性部分组成,1个肿瘤仅由实性部分组成。增强CT显示实性部分在动脉期轻度强化,门静脉期明显强化。囊性部分在平扫及增强CT图像上均呈低密度影。肿瘤有完整包膜,增强扫描后包膜明显强化,边界清晰。(2)所有病例均未见胆总管或胰管扩张,1例合并右肾上腺神经节细胞瘤。(3)5个肿瘤位于胰头,其中3个压迫并推移肠系膜上静脉,2例血管部分被肿瘤包绕。6个肿瘤位于胰尾,其中3个压迫脾门,脾静脉多发迂曲、扩张,静脉分别从肿瘤前后方汇入肠系膜上静脉。2例出现脾静脉受压及向后移位。1例肿瘤与脾门之间界限不清。

结论

SPTP具有特征性CT表现,结合临床特点可作出正确诊断。后处理技术能显示病变与周围结构的关系,有助于手术治疗。

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