發(fā)布時間：2018-04-07 17:35

  本文選題：胰腺　切入點：胰腺內(nèi)副脾　出處：《臨床放射學(xué)雜志》2017年04期

【摘要】：目的回顧性分析胰腺內(nèi)副脾表皮樣囊腫(ECIPAS)的臨床及影像學(xué)表現(xiàn),提高對該病的認(rèn)識及診斷水平。方法搜集經(jīng)手術(shù)病理證實的5例胰腺內(nèi)副脾表皮樣囊腫的臨床及影像學(xué)資料,分析其臨床特征、CT及MRI表現(xiàn),影像學(xué)特征包括:位置、大小、鈣化、囊的特征、密度(信號)及強化特點。結(jié)果 5例患者均為女性,均為體檢偶然發(fā)現(xiàn),3例CA19-9升高。行CT檢查者4例,行MRI檢查者3例。5例均發(fā)生于胰尾內(nèi),其中1例與脾臟分界不清;病灶長徑2.0~5.5 cm,平均為3.4 cm;3例表現(xiàn)為多囊,1例為單囊,1例呈囊實性;3例邊緣顯示為"厚壁"的實性成分,平掃密度/信號、多期動態(tài)增強表現(xiàn)與脾臟類似,給出了提示性診斷;2例壁菲薄,無明顯周圍副脾樣組織,其中1例內(nèi)部見部分實性成分,增強掃描輕度強化,術(shù)前分別診斷為胰腺囊腺瘤及實性假乳頭狀瘤。結(jié)論ECIPAS是一種非常少見的病變,發(fā)生在胰尾部的囊性或囊實性病變,應(yīng)考慮到ECIPAS的可能,尤其在動態(tài)增強檢查時發(fā)現(xiàn)類似于脾臟改變的囊壁。然而一些缺乏囊壁或囊壁菲薄的病變術(shù)前診斷困難,需要病理確診。
[Abstract]:Objective to analyze retrospectively the clinical and imaging features of epidermoid cyst of the accessory spleen of pancreas (ECIPASA) and to improve the understanding and diagnosis of the disease.Methods the clinical and imaging data of 5 cases of epidermoid cyst of the accessory spleen of pancreas proved by operation and pathology were collected. The clinical features of CT and MRI were analyzed. The imaging features included location, size, calcification and cyst.Density (signal) and enhancement characteristics.Results all 5 cases were female, and 3 cases of CA19-9 were found to be elevated by physical examination.Ct examination was performed in 4 cases, MRI in 3 cases in 5 cases occurred in the pancreatic tail, in which 1 case was indistinct from the splenic boundary.The mean length of lesion was 2. 0 ~ 5. 5 cm, with an average of 3. 4 cm, 3 cases with polycystic lesion, 1 case with single cyst, 1 case with solid and solid cyst, 3 cases with "thick wall" solid component, plain scan density / signal, and multi-phase dynamic contrast enhanced appearance was similar to that of spleen.Two cases with thin wall and no peripheral paripplegic tissue were presented as indicative diagnosis. In one case, partial solid components were found in the inner part, enhanced slightly, and were diagnosed as pancreatic cystadenoma and solid pseudopapillary tumor before operation, respectively.Conclusion ECIPAS is a rare disease. Cystic or solid lesions occurring in the tail of pancreas should be taken into account, especially the cystic wall similar to splenic changes found during dynamic contrast enhancement.However, the diagnosis of some lesions lacking or thin cystic wall is difficult before operation and needs to be confirmed by pathology.
【作者單位】： 浙江大學(xué)醫(yī)學(xué)院附屬邵逸夫醫(yī)院放射科;
【分類號】：R576;R816.5;R445.2

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1 杜新榮,呂奎榮,安豐新;脾表皮樣囊腫的CT診斷(附4例報告)[J];齊魯醫(yī)學(xué)雜志;2001年03期

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本文編號：1720174