超声及超声造影对胰腺实性假乳头状瘤的诊断价值(1)
[摘要] 目的 探讨胰腺实性假乳头状瘤(SPTP)的常规超声及超声造影特点，结合临床特征及CT表现，旨在提高超聲医师对该病的诊断能力。 方法 对13例经手术病理证实的SPTP患者的临床特征、常规超声、超声造影及CT表现进行回顾性总结分析。 结果 13例患者中，男女比例1∶2.25，平均年龄(30.92±12.41)岁，超声表现肿块最大径3.0～16.8 cm，7例形态规则，12例边界光滑，12例包膜完整，12例为囊实性混合回声，8例可见少许血流信号，3例可见钙化，1例主胰管扩张。3例超声造影中，2例包膜完整，病灶实性区增强早期有等增强表现，其内无回声区不增强。 结论 常规超声能较准确地判断肿瘤内部囊实性成分及血流情况，超声造影病灶实性区增强早期有等增强表现，其内囊性区始终无增强，结合患者临床特征及CT表现，有助于超声医师对SPTP的诊断。
[关键词] 胰腺实性假乳头状瘤；超声；超声造影；CT
[中图分类号] R445.1；R735.9 [文献标识码] B [文章编号] 1673-9701(2016)36-0121-03
[Abstract] Objective To explore the characteristics of conventional ultrasound and contrast-enhanced ultrasonography in SPTP combined with clinical features and CT performance to improve ultrasound physician's ability of diagnosing the disease. Methods The clinical features， routine ultrasound，contrast-enhanced ultrasonography and CT findings of 13 patients with SPTP confirmed by operation and pathology were analyzed retrospectively. Results Among the 13 patients， the ratio of male to female was 1∶2.25， the average age was(30.92±12.41) years old. Ultrasound showed that the maximal diameter of the mass was 3.0-16.8 cm， with 7 cases in regular shape， 12 cases of smooth boundary and 12 cases of intact capsule and 12 cases of cystic mixed echo. A little blood flow signal could be seen in 8 cases， and calcification could be seen in 3 cases.1 case had pancreatic duct dilatation. In 3 cases of contrast-enhanced ultrasonography， complete capsule was seen in 2 cases， and enhanced performance could be seen at early stage， while the inner echo-free zone was not enhanced. Conclusion Conventional ultrasound can accurately judge the cystic components and blood flow in the tumor. Enhanced performance can be seen at early stage by contrast-enhanced ultrasonography， while the inner echo-free zone is not enhanced. Ultrasound and contrast-enhanced ultrasonography， combined with the clinical features and CT manifestations， help ultrasound physician to diagnose SPTP.
[Key words] Pancreatic solid pseudopapillary tumor； Ultrasound； Contrast-enhanced ultrasonography； CT
在胰腺的占位性病变中，胰腺实性假乳头状瘤(solid pseudopapillary tumor of pancreas，SPTP)是一种罕见的胰腺外分泌肿瘤。由于SPTP较少见且临床表现缺乏特异性，术前超声定性诊断困难，所以易被误诊。本文回顾性分析13例在本院经手术病理证实的SPTP患者的常规超声、超声造影声像图特点，并结合其临床特征及CT表现，旨在提高超声医师对该病的认知程度，提高超声检查对该病的诊断准确率。
1 资料与方法
1.1 临床资料
收集2009年1月～2016年6月我院收治的均经手术治疗及术后病理证实的SPTP患者共13例。其中，13例患者行常规超声检查，3例行超声造影检查，13例行增强CT检查。
1.2 仪器与方法
采用LOGIQ E9彩色多普勒超声诊断仪，凸阵探头，频率2～2.5 MHz。超声造影剂采用声诺维(SonoVue，意大利Bracco公司)，用5.0 mL生理盐水稀释，充分震荡后经肘前静脉团注2.4 mL，再用生理盐水5.0 mL快速冲管。造影开始时计时并启动存储功能，存储时间不少于2 min。 (潘燕 刘利平 赵育芳)
[关键词] 胰腺实性假乳头状瘤；超声；超声造影；CT
[中图分类号] R445.1；R735.9 [文献标识码] B [文章编号] 1673-9701(2016)36-0121-03
[Abstract] Objective To explore the characteristics of conventional ultrasound and contrast-enhanced ultrasonography in SPTP combined with clinical features and CT performance to improve ultrasound physician's ability of diagnosing the disease. Methods The clinical features， routine ultrasound，contrast-enhanced ultrasonography and CT findings of 13 patients with SPTP confirmed by operation and pathology were analyzed retrospectively. Results Among the 13 patients， the ratio of male to female was 1∶2.25， the average age was(30.92±12.41) years old. Ultrasound showed that the maximal diameter of the mass was 3.0-16.8 cm， with 7 cases in regular shape， 12 cases of smooth boundary and 12 cases of intact capsule and 12 cases of cystic mixed echo. A little blood flow signal could be seen in 8 cases， and calcification could be seen in 3 cases.1 case had pancreatic duct dilatation. In 3 cases of contrast-enhanced ultrasonography， complete capsule was seen in 2 cases， and enhanced performance could be seen at early stage， while the inner echo-free zone was not enhanced. Conclusion Conventional ultrasound can accurately judge the cystic components and blood flow in the tumor. Enhanced performance can be seen at early stage by contrast-enhanced ultrasonography， while the inner echo-free zone is not enhanced. Ultrasound and contrast-enhanced ultrasonography， combined with the clinical features and CT manifestations， help ultrasound physician to diagnose SPTP.
[Key words] Pancreatic solid pseudopapillary tumor； Ultrasound； Contrast-enhanced ultrasonography； CT
在胰腺的占位性病变中，胰腺实性假乳头状瘤(solid pseudopapillary tumor of pancreas，SPTP)是一种罕见的胰腺外分泌肿瘤。由于SPTP较少见且临床表现缺乏特异性，术前超声定性诊断困难，所以易被误诊。本文回顾性分析13例在本院经手术病理证实的SPTP患者的常规超声、超声造影声像图特点，并结合其临床特征及CT表现，旨在提高超声医师对该病的认知程度，提高超声检查对该病的诊断准确率。
1 资料与方法
1.1 临床资料
收集2009年1月～2016年6月我院收治的均经手术治疗及术后病理证实的SPTP患者共13例。其中，13例患者行常规超声检查，3例行超声造影检查，13例行增强CT检查。
1.2 仪器与方法
采用LOGIQ E9彩色多普勒超声诊断仪，凸阵探头，频率2～2.5 MHz。超声造影剂采用声诺维(SonoVue，意大利Bracco公司)，用5.0 mL生理盐水稀释，充分震荡后经肘前静脉团注2.4 mL，再用生理盐水5.0 mL快速冲管。造影开始时计时并启动存储功能，存储时间不少于2 min。 (潘燕 刘利平 赵育芳)