胰腺腺泡细胞癌的计算机断层扫描及磁共振成像影像学特征分析
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1.第二军医大学附属长海医院影像医学科;2.第二军医大学附属长海医院介入治疗科

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国家自然科学基金青年科学基金(81601468),上海市科学技术委员会科研计划项目(17411952200).


Computed tomography and magnetic resonance imaging features of acinar cell carcinoma of pancreas
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1.Department of Radiology,Changhai Hospital of Second Military Medical University;2.Department of Interventional Radiology,Changhai Hospital of Second Military Medical University

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    摘要:

    目的探讨胰腺腺泡细胞癌的计算机断层扫描(CT)及磁共振成像(MRI)影像学特征。方法回顾性分析经手术或穿刺活组织检查证实为胰腺腺泡细胞癌的5例患者的病例资料,其中2例行CT平扫加增强检查,2例行MRI平扫加增强检查,1例既行CT平扫加增强又行MRI平扫加增强检查。分析5例患者的临床资料及肿瘤影像学特征。结果肿瘤发生在胰头钩突1例、胰尾4例。病灶最大径为44.6~142.3 mm,平均为86.14 mm。5例患者病灶密度或信号均不均匀。1例患者病灶内部见出血、坏死、钙化,余4例内部仅见坏死。位于胰头的1例肿瘤包膜完整,位于胰尾的4例肿瘤包膜均不完整。5例肿瘤强化程度均低于正常胰腺实质,均于门静脉期达到强化峰值,内部均有坏死。病灶位于胰头钩突的1例患者伴有胰胆管扩张;位于胰尾部的4例肿瘤均侵犯脾静脉,其中2例有肝脏转移瘤。结论胰腺腺泡细胞癌在CT及MRI图像上具有一定的特征性,有助于诊断及鉴别诊断。

    Abstract:

    Objective To assess the computed tomography (CT) and magnetic resonance imaging (MRI) features of acinar cell carcinoma of pancreas (ACCP). Methods The clinical data of 5 patients with ACCP confirmed by operation or biopsy were retrospectively analyzed. Among them, 2 patients underwent CT plain scan and enhanced scan, 2 underwent MRI plain scan and enhanced scan, and 1 underwent both CT and MRI plain scan and enhanced scan. The clinical data and imaging features of 5 patients were analyzed. Results The tumor of 1 case occurred in the uncinate process of head of pancreas, and 4 cases in the tail of pancreas. The maximum diameter of the lesion was 44.6-142.3 mm, with an average of 86.14 mm. The density or signal of tumors was not uniform in the 5 patients. Hemorrhage, necrosis and calcification were found in 1 patient, while the other 4 patients only had necrosis. The tumor capsule was intact in 1 case, with tumor located at the head of pancreas, and the capsules were incomplete in the other 4 cases. The enhancement of tumors in the 5 cases was lower than that of normal pancreatic parenchyma and reached the peak value in portal vein phase, and the tumors of all cases had internal necrosis. The patient whose lesion located at the uncinate process of pancreatic head had dilatation of pancreaticobiliary duct. Four tumors located at the tail of pancreas invaded splenic vein, and 2 of them had hepatic metastasis. Conclusion ACCP is characteristic on CT and MRI images, which is helpful for diagnosis and differential diagnosis.

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  • 收稿日期:2018-08-24
  • 最后修改日期:2018-10-09
  • 录用日期:2019-03-18
  • 在线发布日期: 2019-04-10
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