ISSN 1004-4140
CN 11-3017/P

胰腺脂肪瘤的CT和MRI诊断研究

Study of CT and MRI Diagnosis for the Pancreatic Lipomas

  • 摘要: 目的:探讨CT和MRI检查对胰腺脂肪瘤的诊断价值。材料和方法:回顾性分析9例胰腺脂肪瘤患者的CT(<i<n</i<=7)和MRI(<i<n</i<=2)表现。CT扫描设备为美国GE公司的Lightspeed多排CT机,MRI系统为GE Signa Excite HD 3.0T超导磁共振仪。平扫CT及增强CT描述脂肪瘤的形态、密度和强化表现,平扫MRI不同脉冲序列及增强T1WI描述脂肪瘤的信号变化及强化表现,分析不同影像检查技术对胰腺脂肪瘤的诊断价值。结果:本组病例胰腺脂肪瘤在轴面图像的大小从0.7cm×0.7cm到3.3cm×4.2cm不等,平均大小1.5cm×2.3cm,其中位于胰头5例,胰体3例,胰尾1例,病变形态呈圆形2例、卵圆形5例、不规则形2例。7例胰腺脂肪瘤平扫CT均表现为胰腺实质内边界清晰的低密度肿块,CT值介于-74~-108Hu,平均-91Hu±3.01Hu,静脉注射对比剂后增强扫描时无明显强化改变,CT值介于-66~-98Hu,平均-87Hu±2.15Hu,平扫和增强CT上的平均CT值差异无统计学意义(<i<P</i<>0.05)。脂肪瘤较大时病变区可见散在的血管或间隔影。2例胰腺脂肪瘤在非脂肪抑制T1WI和T2WI均表现为高信号,在脂肪抑制T1WI和T2WI均表现为低信号,其MR信号强度表现与胰腺周围的脂肪组织信号一致。结论:CT和MRI检查能够对胰腺脂肪瘤做出明确诊断。

     

    Abstract: Objective: The purpose of this study was to investigate the value of CT and MRI in diagnosing pancreatic lipomas. Materials and Methods: A retrospective study was carried out in 9 patients with pancreatic lipomas. CT scanner was Lightspeed multi-slice device, MRI system was Signa Excite HD 3.0T superconducting unit. The patients included four male and five female, their ages ranged from 35 to 75 years old, mean 51 years old. Two experienced doctors analyzed CT and MRI findings of the lipomas, including morphology, density and enhancing appearance on CT(<i<n</i< = 7), as well as MR signal intensity in various pulse sequence and enhancing appearance in T1 WI following administration of Gd-DTPA on MRI(<i<n</i< = 2). Results: The size of the lipomas in the nine cases ranged from 0.7 cm × 0.7 cm to 3.37 cm × 4.2 cm, mean size was 1.57 cm × 2.3 cm in the axial imaging plane. The lesions located in the pancreatic head in 5, pancreatic body in 3, pancreatic tail in 1 case, and they appeared as round shape in 2, oval shape in 5 and irregularity in 2 cases. CT revealed well-circumscribed masseswith fatty density in the pancreas, the measured CT value was between-74 Hu and-108 Hu, mean value was-91 Hu ± 3.01 Hu. Obvious enhancement was not observed on post-contrast CT following iodine contrast administration, the CT value was between-66 Hu and-98 Hu, mean value was-87 Hu ± 2.15 Hu, a slight rise was noted somehow by comparing with the pre-contrast CT scans. No statistically significant difference was found between mean CT value of pre- and post-contrast CT scan(<i<P</i< > 0.05). A few scattered shadows indicating vessels and/or septa may be seen within larger lipomas. On MRI examinations, the lipomas showed high signal intensity on conventional T1 WI and T2 WI, but low signal intensity on fat-suppressed T1 WI and T2 WI, the alterations of the MR signal intensity are consistent with those of the fatty tissue around the pancreas. Conclusion: CT and MRI examinations were definitely diagnostic for lipomas of the pancreas.

     

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