李梅莲 温凤玲 陈国亨 许春媚

[摘要] 目的 分析胰腺實性-假乳头状瘤（solid pseudo-papillary tumor of the pancreas，SPTP）的非典型影像学表现。方法 于2015年10月—2018年10月共方便选取研究对象11例，均为经病理学检查确诊为SPTP的患者，开展回顾性分析，分别将进行多排螺旋CT和MRI分为A、B组，进行影像学分析。结果 纳入该次研究的11例患者，其中年龄、性别差异有统计学意义（χ2=7.021、4.665，P<0.05）。年轻组囊性退变发生率72.73%高于老龄组9.09%，差异有统计学意义（χ2=5.264，P<0.05）;大肿瘤实质内囊变63.64%、出血63.64%和假包膜72.73%发生率明显高于小肿瘤9.09%、18.18%、9.09%，差异有统计学意义（P<0.05）;两组对于肿瘤包膜、囊变以及增强模式的能力上差异无统计学意义（P>0.05），A组显示瘤内钙化9例优于B组1例，B组显示瘤内出血10优于A组1例，差异有统计学意义（P<0.05）。结论 SPTP好发于年轻女性，具有典型影像学表现，其中年龄超过40岁以上的女性会男性 SPTP的影像学表现多为实性肿瘤，临床需结合多种影像学检查进行诊断。

[关键词] 胰腺;实性-假乳头状瘤;非典型;影像学;表现

[中图分类号] R445.1          [文献标识码] A          [文章编号] 1674-0742（2019）11（a）-0193-03

Atypical Imaging Findings of Solid-pseudopapillary Tumor of the Pancreas

LI Mei-lian， WEN Feng-ling， CHEN Guo-heng， XU Chun-mei

CT and MR Room， People's Hospital of Zhanjiang Center， Zhanjiang，Guangdong Province， 524045 China

[Abstract] Objective To analyze the atypical imaging findings of solid pseudo-papillary tumor of the pancreas （SPTP）. Methods From October 2015 to October 2018， convenient seleeted 11 patients were enrolled in the study. All patients who were diagnosed as SPTP by pathology were retrospectively analyzed. Multi-slice spiral CT and MRI were performed. Divided into groups A and B for imaging analysis. Results Of the 11 patients included in the study， there were statistically significant differences in age and gender （χ2=7.021， 4.665， P<0.05）. The incidence of cystic degeneration in the young group was 72.73% higher than that in the old group 9.09%， The difference was statistically significant（χ2=5.264， P<0.05）; the large intratumoral capsule change was 63.64%， the bleeding was 63.64%， and the incidence of the false capsule was 72.73%. Compared with small tumors， 9.09%， 18.18%， and 9.09%，The difference was statistically significant（P<0.05）; there was nostatistically significant difference in the ability of tumor capsule， cystic and enhanced pattern between the two groups， and group A showed intratumoral calcification（P>0.05）. The case was better than the B group， and the B group showed that the intratumoral hemorrhage was better than the A group， and The difference was statistically significant（P<0.05）. Conclusion SPTP occurs in young women with typical imaging findings. Among women over 40 years old， the imaging findings of SPTP in men are mostly solid tumors. Clinical diagnosis is to be combined with multiple imaging examinations.

[Key words] Pancreas; Solid-pseudopapillary tumor; Atypical; Imaging; Performance

SPTP目前临床上不管是组织起源还是发病机制均不明确[1]。该次研究从2015年10月—2018年10月期间筛选11例，重点对已经经病理学检查确诊的SPTP患者进行影像学分析，旨在能够提高SPTP的临床诊断准确性，现报道如下。

1  资料与方法

1.1  一般资料

将该院收治的11例SPTP患者作为研究对象，有男性患者2例，有女性患者9例，患者的年龄范围年龄在33～80岁之间，平均年龄（34.05±3.79）岁，肿瘤直径最大5.35 mm×3.66 mm，最小直径2.02 mm×1.86 mm。纳入该次研究的所有患者均充分、全面了解该研究相关情况，并且该研究得到该院伦理委员会的批准与认可。

（1）纳入标准：①经手术病理学检查确诊SPTP[2];②接受临床影像学检查依从性良好。

（2）排除标准：①合并其他恶性肿瘤;②依从性极差无法配合开展影像学检查者。合并身心障碍、视听障碍;③精神异常者。

1.2  方法

所有纳入此次研究的11例患者均接受多排螺旋CT和MRI检查。

A组，多排螺旋CT：使用该院螺旋CT进行扫描，使用高压注射器，控制流速在5.0 mL/s，经静脉注入非离子型造影剂120 mL， 动脉期20 s，胰腺期45 s，肝脏实质期80 s，管电压120 kV，管电流250 mA，螺距1.0，准直0.625～5 mm，矩阵512×512，采用标准重建算法。……