目的:分析胰腺实性-假乳头状瘤的螺旋CT征象及病理特点,提高术前诊断水平。方法:回顾性分析24例胰腺SPT的螺旋CT征象,包括肿瘤的部位、大小、形态、边界、密度、强化方式、强化程度、囊实比例、钙化、临近组织器官侵犯及淋巴结转移等,并与手术结果及病理对照分析。结果:1)肿瘤发生于胰头部10例,体部7例,尾部6例,体尾部1例,大部分呈圆形或类圆形,部分有分叶,边界清楚,有完整包膜。2)肿瘤内部可见实性及囊性成分,实性部CT平扫呈稍低或等密度,增强扫描动脉期轻至中度强化,门脉期进一步强化,与胰腺实质最大密度差出现在动脉期,囊性部分平扫及增强扫描均呈低密度。3)囊性为主型6例,实性为主型8例,囊实相仿型10例。4)8例肿瘤内部可见钙化,其中一例呈蛋壳状钙化,6例胰管轻度扩张,1例胆总管、肝内胆管可见扩张。5)9例患者CT征象见恶性倾向,1例呈弥漫性生长,5例推压、包绕脾血管,2例与肠系膜血管粘连,1例肿瘤包绕右肾静脉,其余15例CT表现为良性,包膜完整,与周围器官、组织分界清楚,术中所见有一定差异。结论:胰腺SPT病理学特点明显,螺旋CT征象有一定特征,肿瘤呈囊实性两部分,血供较为丰富,呈逐渐强化改变,与大多数胰腺癌缺乏血供有较大差别,血浆CEA阴性也有较大的参考价值,CT检查对胰腺SPT的术前诊断、良恶性判断、治疗方法的选择均有重要意义。 Objective: To analyze the spiral CT features and pathological features of solid pancreatic pseudopapillary tumor and to improve the preoperative diagnosis. Methods: The CT features of 24 cases of SPT were retrospectively analyzed. The location, size, shape, boundary, density, enhancement mode, degree of enhancement, ratio of cyst, calcification, adjacent tissue and organ invasion and lymph node metastasis were all analyzed retrospectively. Surgical results and pathological control analysis. Results: 1) The tumor occurred in 10 cases of the head of pancreas. There were 7 cases in the body, 6 cases in the tail and 1 case in the tail of the body. Most of them were round or oval, with partial lobes, clear boundary and complete capsule. 2) The solid and cystic components were visible in the tumor. The CT scan of the solid part showed a slightly lower or isodense density, which enhanced the mild to moderate enhancement of the arterial phase and enhanced the portal venous phase. The difference with the maximum density of the pancreatic parenchyma appeared in the artery Period, cystic part of the plain scan and enhanced scan were low density. 3) cystic-based 6 cases, 8 cases of solid-based, cystic resemblance in 10 cases. 4) 8 cases of calcification within the tumor, one case was egg-shaped calcification, 6 cases of mild pancreatic dilation, 1 case of common bile duct, intrahepatic bile duct can be seen expansion. 5) Nine patients had malignant CT signs, one showed diffuse growth, 5 cases pushed around the splenic vessels, 2 cases had adhesion with mesenteric vessels, 1 case surrounded the right renal vein and the other 15 cases showed CT Benign, complete capsule, with the surrounding organs, clear organizational boundaries, intraoperative findings have some differences. Conclusion: There are obvious pathological features of SPT in pancreas. Spiral CT signs have some characteristics. The tumor has cystic solidity, the blood supply is more abundant, showing a gradual enhancement. Compared with most pancreatic cancers, there is a big difference between the lack of blood supply and the negative CEA Also have greater reference value, CT examination of pancreatic preoperative diagnosis of SPT, benign and malignant judgment, the choice of treatment methods are of great significance.