目的:探讨胰腺实性假乳头状瘤(SPTP)的多排螺旋CT(MDCT)表现特征及诊断价值.方法:回顾性分析经手术和病理证实的5例SPTP患者的MDCT影像学资料和临床资料.结果:5例均为单发,胰头颈部1例,胰颈部1例,胰体部1例,胰体尾部2例,4例呈混合性,1例为实性.5例均有包膜,与胰腺实质分界清楚,其中1例恶性SPTP肿块巨大,包膜不完整,局部与邻近结构分界不清,4例良性SPTP包膜完整,边界清楚.三期增强实性成分动脉期轻度强化,门脉期、延迟期进一步强化,但密度均低于正常胰腺实质,囊性部分三期均未见强化,介于囊实性密度之间的过渡区呈轻度延迟强化,肿瘤包膜亦呈延迟强化,2例肿瘤边缘见点条状钙化.后处理技术能多方位显示肿块与胰腺呈“杯口”状相交或“抱球”状改变,并可多角度观察邻近结构受压、侵犯情况及邻近血管改变.结论:MDcT能显示SPTP的主要病理改变,其动态增强及后处理技术对本病具有重要诊断价值.%Objective: To investigate the multi-detector row spiral CT ( MDCT) features of solid pseudopapillaiy tumor of pancreas (SPTP) and evaluate its diagnostic value in this disease. Methods: The clinical data were reviewed and analyzed in 5 patients surgically and pathologically confirmed SPTP regarding MDCT imaging findings. Results: The total 5 were solitary tumors, in which neoplasm of pancreatic head and neck was seen in 1 case, pancreatic neck in 1, body of pancreas in 1, and pancreatic body and tail in 2. Besides,4 cases showed mixed density and 1, solid. The CT image exhibited enhanced capsule and well-defined margin with the pancreatic parenchyma in 5 cases, in which 1 malignancy was huge, with defected capsule and partial dark margin with the proximal structures, whereas 4 benign, cases were seen entire capsule and well-defined boundary. Three phases of enhancement showed that the solid components were slightly enhanced in arterial phase and extended in portal and delayed phases, yet the density appeared lower than that of nermal pancreas. Enhancement, absent from the cystic part in the three phases, appeared between the solid and cystic density transition zone that was mildly delayed and identical with tumor capsule. Strip-shaped calcification of the tumor edge was seen in 2 cases. Post-processing correction displayed in entire dimensions a cup-shaped intersection with the lesion and pancreas or a change like "holding a ball" ,and exposed involvement of the com-pressed adjacent structures with invasive and vascular alteration. Conclusion ; MDCT can show the important pathological changes of SPTP, and application of dynamically contrast-enhanced and post-processing techniques has important diagnostic value for this neoplasm.
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