21例胰腺转移性肿瘤的CT表现

摘要

Background and purpose: Pancreatic metastasis is relatively rare with delitescent clinical manifestation and often neglected or underestimated in clinical practice, the accurate identification of pancreat primary and metastasis tumor is of great importance on the treatment. This study aimed to evaluate the CT features of pancreatic metastasis and to compare with primary pancreatic tumors. Methods: The clinical data and CT images of 21 patients with pancreatic metastases, who received treatment in Cancer Center, Fudan University, were analyzed retrospectively.The location, number, size and enhancement, vessel invasion and the primary lesion of matastasis tumor were observed and assessed Results: (1)The primary malignancy was lung cancer in 6 patients, renal cell carcinoma in 3 patients,sarcoma in 3 patients, lymphoma in 3 patients, gastric cancer in 2 patients, ovarian carcinoma in 1 patient, colon carcinoma in 1 patient, cervical cancer in 1 patient and laryngeal cancer in 1 patient. (2)The type of metastases was solitary in 10 patients, multiple in 9 patients and diffuse in 2 patients. (3)The metastases was hypodense in 19 patients,hyperdense in 1 patient and isodense in 1 patient. These lesions were ring-shape enhancement in 13 patients, slight enhancement in 6 patients, no enhancement in 1 patient and homogeneous enhancement in 1 patient. (4)Twenty patients had metastases to other organs. Conclusion: The metastasis is often located in the body and tail of pancreas with ringshape or significant homogeneous enhancement in the arterial phase .and rare extension of pancreatic duct or vessel invasion on CT scan. The characteristic feature, combined with medical history and clinical data, can improve the diagnostic accuracy of the metas tases to the pancreas.%背景与目的:胰腺转移性肿瘤较为少见,其临床表现比较隐匿并且缺乏特异性,常常不易引起临床的重视,胰腺原发和转移性肿瘤能否得以准确诊断对两者治疗方案的选择有很大影响.本文旨在探讨胰腺转移性肿瘤的CT成像特征.方法:分析在复旦大学附属肿瘤医院接受治疗的21例胰腺转移性肿瘤患者的临床资料及CT表现,观察和评价转移性肿瘤发生的部位、数量、大小、强化方式、血管侵犯和原发灶的情况.结果:(1)21例胰腺转移性肿瘤患者中,原发肿瘤为肺癌者6例,肾癌、淋巴瘤及肉瘤者各3例,胃癌者2例,卵巢、宫颈、结肠及喉部患者各1例.(2)单发病灶10例,包括3例原发灶为肺癌,2例为肾癌,胃癌、淋巴瘤、喉癌、卵巢癌及宫颈癌各1例:多发病变9例,其中肺癌3例、肉瘤3例,肾癌、淋巴瘤及结肠癌各占1例;弥漫增大的病灶2例,淋巴瘤及胃癌各1例.(3)转移病变中低密度灶有19例,等密度1例,高密度1例;增强后13例呈环形强化,1例无强化,6例不明显强化,1例均匀明显强化.(4)20例伴有胰外器官的转移.结论:胰腺转移性肿瘤CT表现为多发生在胰体、尾,动脉期呈环形强化或明显均匀强化,较少引起胰管扩张及侵犯胰周血管,上述CT特点结合病史及临床资料可以提高胰腺转移性肿瘤CT诊断的准确率.