CAJ | 학술논문

目的：探讨胰腺实性假乳头状瘤的超声US、CT及MRI表现，旨在提高对实性假乳头状瘤的认识，提高影像诊断准确率。方法回顾性分析2003年2月～2013年8月12例经手术病理证实的SPTP患者的US、CT、MRI特征及临床资料。结果12例声像图呈实性、囊性或囊实混合性回声，CDFI多见点状血流；CT表现8例见钙化，依据肿瘤内实性和囊性成分比例不同，动脉期轻至中度强化，门脉期及延迟期呈渐进性强化，病灶增强扫描各期强化强化程度始终低于正常胰腺实质；M RI平扫囊性成分病灶在 T1 WI呈明显低信号，T2 WI呈明显高信号；病变内实性成分 T1 WI呈低信号，T2WI等或略高信号；DWI呈高信号，增强扫描强化模式与CT强化模式相仿。结论 SPTP临床表现无特异性，好发于年轻女性，术前诊断主要依赖US、CT、MRI检查。影像学检查能够明确病变位置、大小及周围情况，为临床制定合理的手术方案提供更准确的信息，改善患者预后。
목적：탐토이선실성가유두상류적초성US、CT급MRI표현，지재제고대실성가유두상류적인식，제고영상진단준학솔。방법회고성분석2003년2월～2013년8월12례경수술병리증실적SPTP환자적US、CT、MRI특정급림상자료。결과12례성상도정실성、낭성혹낭실혼합성회성，CDFI다견점상혈류；CT표현8례견개화，의거종류내실성화낭성성분비례불동，동맥기경지중도강화，문맥기급연지기정점진성강화，병조증강소묘각기강화강화정도시종저우정상이선실질；M RI평소낭성성분병조재 T1 WI정명현저신호，T2 WI정명현고신호；병변내실성성분 T1 WI정저신호，T2WI등혹략고신호；DWI정고신호，증강소묘강화모식여CT강화모식상방。결론 SPTP림상표현무특이성，호발우년경녀성，술전진단주요의뢰US、CT、MRI검사。영상학검사능구명학병변위치、대소급주위정황，위림상제정합리적수술방안제공경준학적신식，개선환자예후。
Objective To investigate the ultrasound (US) ,CT and MRI features of pancreatic solid pseudo papillary tumor (SPTP) ,so as to enhance the knowledge of solid pseudo papillary tumor ,and to improve the accuracy of imaging diagnosis .Methods The CT ,MRI features and clinical data of 12 cases of SPTP proved by operation and pathology from February 2003 to August 2013 were analyzed retrospectively .Results 11 patients in this group were female ,with mean age 26 .5 years .The clinical symptoms and laboratory examination were no specific .Calcification was seen in 8 cases .US showed solid ,cystic or mixed echo ,CDFI showed dotted blood flow ;CT manifestations of SPTP depended on different proportion of solid and cystic components within the tumor on plain scanning .Mild to moderate enhancement were seen during the arterial phase ,portal venous phase and delayed phase showed progressive enhancement ,and always lower than normal pancreatic parenchyma ;On MRI plain scan ,most lesions manifested as obviously low signal on T1WI ,and obvi-ously high signal on T2 WI;solid components showed up as low signal on T1 WI ,isointense or slightly higher signal on T2WI;DWI mostly showed high signal ,and enhancement pattern was similar to CT .Conclusion SPTP has no specific clinical manifestations ,and usually occurs in the young female .Preoperative diagnosis relies mainly on US ,CT ,MRI ex-amination .Imaging examination can indicate the location ,size and the surrounding situation of lesions ,provide much more accurate information for clinician ,and improve the prognosis of patients .