CAJ | 학술논문

目的研究胰腺实性假乳头状瘤的CT表现及图像后处理技术在外科手术中的价值.方法回顾性分析14例经手术病理证实的胰腺实性假乳头状瘤的临床特征及CT表现.结果 (1)13例肿瘤由实性部分和囊性部分构成,1例肿瘤为单纯实性.肿瘤实性部分动脉期呈轻度强化,门静脉期明显强化;囊性部分在增强前后均呈低密度.肿瘤有包膜,增强后包膜强化明显,与胰腺分界清晰.(2)14例均无肝内外胆管和胰管扩张,1例伴发右肾上腺节细胞神经瘤.(3)胰头部肿瘤5例,其中3例肠系膜上动静脉受压移位,2例血管部分被肿瘤包绕.胰尾部肿瘤6例,其中3例肿瘤推挤脾门,造成多支脾静脉迂曲扩张,分别从肿瘤的前方和后方汇入肠系膜上静脉;2例显示脾静脉受压后移;1例肿瘤与脾门结构分界不清.结论胰腺实性假乳头状瘤具有较特征性的CT表现,结合临床特征可在术前作出诊断.三维后处理技术可以很好显示肿瘤与邻近结构的关系,为手术治疗提供重要依据.
목적 연구이선실성가유두상류적CT표현급도상후처리기술재외과수술중적개치.방법 회고성분석14례경수술병리증실적이선실성가유두상류적림상특정급CT표현.결과 (1)13례종류유실성부분화낭성부분구성,1례종류위단순실성.종류실성부분동맥기정경도강화,문정맥기명현강화;낭성부분재증강전후균정저밀도.종류유포막,증강후포막강화명현,여이선분계청석.(2)14례균무간내외담관화이관확장,1례반발우신상선절세포신경류.(3)이두부종류5례,기중3례장계막상동정맥수압이위,2례혈관부분피종류포요.이미부종류6례,기중3례종류추제비문,조성다지비정맥우곡확장,분별종종류적전방화후방회입장계막상정맥;2례현시비정맥수압후이;1례종류여비문결구분계불청.결론 이선실성가유두상류구유교특정성적CT표현,결합림상특정가재술전작출진단.삼유후처리기술가이흔호현시종류여린근결구적관계,위수술치료제공중요의거.
Objective To study the CT manifestations of the solid-pseudopapillary tumor of the pancreas (SPTP) and tu 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) 13tumors 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 tortuesity 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.