胰腺实性假乳头状瘤超声诊断分析
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摘要
目的分析胰腺实性假乳头状瘤(SPTP)超声表现及术前诊断情况,探讨SPTP的诊断模式,提高对该病的超声诊断准确度。方法选择40例SPTP患者,其中男性11例,女性29例;年龄7-64岁,平均年龄35.5岁。均行手术治疗和病理诊断,其中32例术前行超声检查,分析超声表现及超声诊断情况。结果 40例SPTP均为单发。术前超声检查漏诊3例,29例SPTP超声多表现为形态较规则,边界较清晰的实性或实性为主病灶,回声不均,缺乏血液供应。24例超声定位诊断正确,15例提示定性诊断,考虑1种疾病者7例(其中1例诊断为SPTP),2种疾病者7例(6例诊断为SPTP),3种疾病者1例(诊断为SPTP)。结论超声诊断SPTP应密切结合临床及流行病学资料,多方位、多切面扫查,诊断结论提示2种可能的疾病,有助于提高诊断符合率,为临床诊疗提供有价值的影像学依据。
Objective To investigate the ultrasound feature and diagnosis of solid pseudopapillary tumor of the pancreas(SPTP), and improve the ultrasound diagnostic coincidence rate. Methods A total of 40 SPTP patients confirmed by surgical pathology were enrolled, which included 11 males and 29 females, aged 7-64 years old with mean age of 35.5 years old. All of them performed surgical treatment and pathological diagnosis, 32 cases underwent ultrasound examination before operation,the ultrasound findings and ultrasound diagnosis were analyzed. Results All SPTP cases were solitary. Three cases were missed diagnosed by preoperative ultrasonography, 29 SPTP ultrasound exhibited regular morphology as solid or solid-dominated with clear boundary, uneven echo and absent of blood flow. Twenty-four cases showed correct localization diagnosis by ultrasound, 15 showed correct qualitative diagnosis, 7 cases were considered with 1 disease(1 was diagnosed as SPTP), 7 were diagnosed with 2 diseases(6 diagnosed with SPTP), and 1 case was considered with 3 diseases(diagnosed as SPTP). Conclusion It is demonstrated that ultrasound diagnosis of SPTP should be closely combined with clinical and epidemiological data in multi-directional and multi-slice scans, and diagnosis with 2 potential diseases may be helpful to improve the diagnostic coincidence rate of ultrasound and provide valuable imaging information for the clinic.
Objective To investigate the ultrasound feature and diagnosis of solid pseudopapillary tumor of the pancreas(SPTP), and improve the ultrasound diagnostic coincidence rate. Methods A total of 40 SPTP patients confirmed by surgical pathology were enrolled, which included 11 males and 29 females, aged 7-64 years old with mean age of 35.5 years old. All of them performed surgical treatment and pathological diagnosis, 32 cases underwent ultrasound examination before operation,the ultrasound findings and ultrasound diagnosis were analyzed. Results All SPTP cases were solitary. Three cases were missed diagnosed by preoperative ultrasonography, 29 SPTP ultrasound exhibited regular morphology as solid or solid-dominated with clear boundary, uneven echo and absent of blood flow. Twenty-four cases showed correct localization diagnosis by ultrasound, 15 showed correct qualitative diagnosis, 7 cases were considered with 1 disease(1 was diagnosed as SPTP), 7 were diagnosed with 2 diseases(6 diagnosed with SPTP), and 1 case was considered with 3 diseases(diagnosed as SPTP). Conclusion It is demonstrated that ultrasound diagnosis of SPTP should be closely combined with clinical and epidemiological data in multi-directional and multi-slice scans, and diagnosis with 2 potential diseases may be helpful to improve the diagnostic coincidence rate of ultrasound and provide valuable imaging information for the clinic.
引文
[1] MENG Xiang-peng, MA Jia, WANG Bao-sheng. Clinical analysis of 71 cases of solid pseudopapillary tumor of pancreas[J]. Journal of Clinical Research,2016,33(4):763-766.[孟祥鹏,马佳,王宝胜.胰腺实性假乳头状瘤71例临床诊治分析[J].医学临床研究,2016,33(4):763-766.]
[2] GUO Lin, LIANG Shi-chao, WANG Shuang, et al. Clinical analysis of solid pseudopapillary tumor of pancreas[J]. Chinese Journal of General Surgery, 2013, 28(9):717-718.[郭琳,梁世超,王爽,等.胰腺实性假乳头状瘤诊疗分析[J].中华普通外科杂志,2013,28(9):717-718.]
[3] Singh P, Patel K, Ramakrishna B. Solid pseudopapillary tumor of the pancreas:A retrospective analysis of 36 cases from a single institution in India[J]. Indian J Cancer, 2015, 52(3):439-442.
[4] Lubezky N, Papoulas M, Lessing Y, et al. Solid pseudopapillary neoplasm of the pancreas:Management and long-term outcome[J]. Eur J Surg Oncol, 2017, 43(6):1056-1060.
[5] GAO Han-qing, PANG Xia, ZHAO Xiang-tian, et al. Correlation of clinicopathologic features and postoperative recurrence or metastasis in solid-pseudopapillary neoplasms of the pancreas[J]. Chinese Journal of Clinical and Experimental Pathology, 2017, 33(12):1316-1319.[高汉青,庞霞,赵香田,等.胰腺实性假乳头状瘤临床病理学与术后复发/转移的相关性分析[J].临床与实验病理学杂志,2017,33(12):1316-1319.]
[6] Beltrame V, Pozza G, Dalla Bona E, et al. Solid-pseudopapillary tumor of the pancreas:a single center experience[J].Gastroenterol Res Pract, 2016, 2016(6):4289736-4289736.
[7] JING Fang-fang, ZHAO Jun-hui, GUO Yang, et al. Solid pseudopapillary tumors of the pancreas:A review of 1 180 patients reported in Chinese literature[J]. Chinese Journal of Pancreatology,2013, 13(2):98-102.[井方方,赵君慧,郭洋,等.国内胰腺实性假乳头状瘤1 180例临床荟萃分析[J].中华胰腺病杂志,2013,13(2):98-102.]
[2] GUO Lin, LIANG Shi-chao, WANG Shuang, et al. Clinical analysis of solid pseudopapillary tumor of pancreas[J]. Chinese Journal of General Surgery, 2013, 28(9):717-718.[郭琳,梁世超,王爽,等.胰腺实性假乳头状瘤诊疗分析[J].中华普通外科杂志,2013,28(9):717-718.]
[3] Singh P, Patel K, Ramakrishna B. Solid pseudopapillary tumor of the pancreas:A retrospective analysis of 36 cases from a single institution in India[J]. Indian J Cancer, 2015, 52(3):439-442.
[4] Lubezky N, Papoulas M, Lessing Y, et al. Solid pseudopapillary neoplasm of the pancreas:Management and long-term outcome[J]. Eur J Surg Oncol, 2017, 43(6):1056-1060.
[5] GAO Han-qing, PANG Xia, ZHAO Xiang-tian, et al. Correlation of clinicopathologic features and postoperative recurrence or metastasis in solid-pseudopapillary neoplasms of the pancreas[J]. Chinese Journal of Clinical and Experimental Pathology, 2017, 33(12):1316-1319.[高汉青,庞霞,赵香田,等.胰腺实性假乳头状瘤临床病理学与术后复发/转移的相关性分析[J].临床与实验病理学杂志,2017,33(12):1316-1319.]
[6] Beltrame V, Pozza G, Dalla Bona E, et al. Solid-pseudopapillary tumor of the pancreas:a single center experience[J].Gastroenterol Res Pract, 2016, 2016(6):4289736-4289736.
[7] JING Fang-fang, ZHAO Jun-hui, GUO Yang, et al. Solid pseudopapillary tumors of the pancreas:A review of 1 180 patients reported in Chinese literature[J]. Chinese Journal of Pancreatology,2013, 13(2):98-102.[井方方,赵君慧,郭洋,等.国内胰腺实性假乳头状瘤1 180例临床荟萃分析[J].中华胰腺病杂志,2013,13(2):98-102.]