Abstract:Objective To analyze the computed tomography (CT) and magnetic resonance imaging (MRI) features of solid pseudopapillary tumor of pancreas (SPTP) and to study the growth characteristics, so as to improve the understanding and diagnosis of SPTP. Methods The clinical data, and CT and MRI data of 103 patients with SPTP confirmed by postoperative pathology, who underwent surgical resection in our hospital between May 2012 and Nov. 2018, were analyzed retrospectively. The gender, age, tumor maximum diameter, tumor location, tumor shape, pseudocapsule, cystic degeneration, intratumoral hemorrhage and calcification were analyzed, and the stratified analysis was carried out according to gender, age, tumor maximum diameter and tumor location. Results A total of 104 lesions (25 lesions in males and 79 in females) of 103 SPTP patients (25[24.3%] males and 78[75.7%] females) were included. The average ages of the males and females were (40.4±11.3) years old and (32.9±12.0) years old, respectively, and the difference was significant (P=0.004). The mean tumor maximum diameters of the males and females were (36.8±25.3) mm and (50.0±31.2) mm, respectively, and the difference was significant (P=0.046). The results of stratified analysis showed that the females were more likely to have pseudocapsule (62 cases), cystic degeneration (41 cases) and intratumoral hemorrhage (37 cases) compared with the males (13 cases, 3 cases and 6 cases, respectively), and the differences were significant (all P<0.05). The patients aged ≤ 40 years old were more likely to have tumor cystic degeneration (37 cases) and intratumoral hemorrhage (37 cases) compared with the patients aged > 40 years old (7 cases and 6 cases, respectively), and the differences were significant (both P<0.01). The tumors with maximum diameter > 3 cm were mainly distributed in the tail of the pancreas (33 cases), and were more likely to have pseudocapsule (59 cases), cystic degeneration (40 cases) and intratumoral calcification (26 cases) compared with the tumors with maximum diameter ≤ 3 cm (14 cases, 16 cases, 4 cases and 5 cases, respectively), and the differences were significant (all P<0.01). The tumors in the tail of the pancreas were more likely to have pseudocapsule (40 cases) and cystic degeneration (25 cases), followed by the tumors in the head of the pancreas (26 cases and 17 cases, respectively), and the differences were significant (both P<0.01). Conclusion The development and progression of SPTP may be a dynamic process of complete solid, cystic solid and cystic changes. At different stages of this process, the imaging manifestations vary with the internal components of the tumors. The tumors in females, in patients aged ≤ 40 years old, in the tail of the pancreas or with the maximum diameter > 3 cm are more likely to have pseudocapsule, cystic degeneration, hemorrhage and calcification.