摘要
目的:探讨胰腺实性假乳头状瘤(solid pseudo papillary tumor of the pancreas,SPTP)和胰腺导管腺癌(pancreatic ductal adenocarcinoma,PDAC)的超声表现特征,并比较分析两者之间超声影像要点。方法:回顾性分析2009年8月至2018年3月我院经手术病理证实的48例SPTP患者和48例PDAC患者的超声检查结果,总结其超声声像图特征及两者之间的鉴别要点。结果:以病理检查结果为金标准,超声检查诊断SPTP及PDAC的符合率分别为68.8%(33/48)和85.4%(41/48)。在超声图像上,SPTP的发病部位、内部回声、钙化及肿块内部血流显示情况均与PDAC极为类似(P>0.05),但SPTP的边缘轮廓清晰率73.9%(34/46)和形态规则率73.9%(34/46)、液化率37.0%(15/42)均明显高于PDAC[28.6%(12/42)、35.7%(15/42)和7.1%(3/42)],而SPTP的主胰管扩张发生率低于PDAC[6.5%(3/46)比35.7%(15/42)],差异均有统计学意义(P<0.01)。上述超声特征中,液化特征鉴别SPTP与PDAC的特异度最高。结论:采用超声对SPTP与PDAC进行初步鉴别具有无创、方便、经济等优点,当超声检查显示胰腺肿块中伴有液化,且边缘清晰、形态规则者,应首先考虑SPTP可能。
Objective:To investigate the ultrasonographic features of solid pseudo papillary tumor of the pancreas(SPTP)and pancreatic ductal adenocarcinoma(PDAC),to initially screen and compare the key points of ultrasonographic diagnosis between the two.Methods:The ultrasound findings of 48 patients with SPTP and 48 patients with PDAC confirmed by surgical pathology in our hospital from August 2009 to March 2018 were retrospectively analyzed.Their ultra-sound sonographic features and the key points for differentiation between them were summarized.Results:Using pathological findings as the gold standard,the coincidence rates of the ultrasound diagnosis of SPTP and PDAC was 68.8%(33/48)and 85.4%(41/48),respectively.On ultrasound images,the origin of the mass,internal echogenicity,calcification and in-ternal blood flow were very similar to those of PDAC(P>0.05).However,the rate of clear margins,regular morphology and liquefaction were significantly higher in SPTP than those in PDAC[SPTP,73.9%(34/46),73.9%(34/46)and 37.0%(15/42);PDAC,28.6%(12/42),35.7%(15/42)and 7.1%(3/42)],whereas the incidence of dilatation of the main pancreatic duct was lower in SPTP than that in PDAC 6.5%(3/46)vs.35.7%(15/42),with a statistically significant difference(P<0.01).Among the above ultrasound features,the liquefaction feature was the most significant criterion for identifying SPTP and PDAC.Conclusion:The use of ultrasound screening to identify SPTP and PDAC has the advantages of being non-invasive,convenient and economical.SPTP should be considered first when ultrasound shows a pancreatic mass with liquefaction in a clear margin and regular shape.
作者
顾炫
柳俊
GU Xuan;LIU Jun(Department of Ultrasound,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《诊断学理论与实践》
2022年第4期504-508,共5页
Journal of Diagnostics Concepts & Practice
关键词
胰腺实性假乳头状瘤
胰腺导管腺癌
超声筛查
Solid pseudo papillary tumor of the pancreas
Pancreatic ductal adenocarcinoma
Ultrasound screening
