摘要
目的分析胰腺导管内管状乳头状肿瘤(ITPN)的临床病理资料及影像学表现,提高对ITPN的认识和影像诊断能力。方法回顾性分析经手术病理证实5例ITPN病人影像表现及临床资料,并复习相关文献。结果 5例ITPN中4例为胰管内实性病灶,CT平扫上呈等或稍低密度,未发现钙化灶。MR T1WI上呈稍低及等信号,T2WI上呈稍高及等低信号,DWI呈高信号,ADC信号较周围胰腺实质减低,病灶长轴与主胰管长轴相一致;1例在CT/MRI表现为弥漫囊性病灶,伴不规则增厚的囊壁及分隔,无钙化灶。增强后在CT/MRI上实性病灶及囊性病灶实性成分均呈轻度渐进性延迟强化,各期强化程度均低于周围胰腺实质。CT/MRI可见"双色导管征",MRCP可见"酒瓶软木塞征"。结论 ITPN罕见,胰腺导管内生长方式的影像学表现具有一定的特征性。
Objective To investigate clinicopathological features and the imaging fingdings of intraductal tubulopapillary neoplasm(ITPN), in order to improve the recognition and imaging diagnosis for ITPN. Methods Five patients with ITPN confirmed by surgical pathology were retrospectively collected to analyze the imaging findings and clinic data in combination with relevant literatures. Results Four patients presented as soft tissue masses growing in the lumen of pancreatic duct. In the four patients, the tumors showed iso-or mild hypo-density and no calcifications on unenhanced CT,mild hypo-or iso-intensity on T1 WI, mild hyper-and iso-or hypo-intensity on T2 WI, hyper-intensity on DWI, and hypointensity on the ADC map compared with surrounding pancreatic parenchyma. The long axis of the lesions were consistent with the long axis of the main pancreatic duct in the four patients. In one patient, the tumor showed multiple cystic lesions and irregularly thickened cystic walls and septa without calcification on CT/MRI. The enhancement of the intraductal solid masses and solid components were slightly delayed and lower than that of the surrounding pancreatic parenchyma in each phases on CT and/or MRI. ITPN could presented as "the 2-tone duct sign" on CT/MRI, and "the cork-of-wine-bottle sign" on MRCP.Conclusion ITPN is rare, and its intraductal growth behavior can be considered as a typical feature.
作者
柴丽
王婷
王晴柔
朱乃懿
柴维敏
CHAI Li;WANG Ting;WANG Qingrou;ZHU Naiyi;CHAI Weimin(Department of Radiology,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China;Department of Pathology,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China)
出处
《国际医学放射学杂志》
北大核心
2020年第4期478-481,共4页
International Journal of Medical Radiology
