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目的回顾性分析胰腺内副脾表皮样囊肿(ECIPAS)的临床及影像学表现,提高对该病的认识及诊断水平。方法搜集经手术病理证实的5例胰腺内副脾表皮样囊肿的临床及影像学资料,分析其临床特征、CT及MRI表现,影像学特征包括:位置、大小、钙化、囊的特征、密度(信号)及强化特点。结果 5例患者均为女性,均为体检偶然发现,3例CA19-9升高。行CT检查者4例,行MRI检查者3例。5例均发生于胰尾内,其中1例与脾脏分界不清;病灶长径2.0~5.5 cm,平均为3.4 cm;3例表现为多囊,1例为单囊,1例呈囊实性;3例边缘显示为“厚壁”的实性成分,平扫密度/信号、多期动态增强表现与脾脏类似,给出了提示性诊断;2例壁菲薄,无明显周围副脾样组织,其中1例内部见部分实性成分,增强扫描轻度强化,术前分别诊断为胰腺囊腺瘤及实性假乳头状瘤。结论ECIPAS是一种非常少见的病变,发生在胰尾部的囊性或囊实性病变,应考虑到ECIPAS的可能,尤其在动态增强检查时发现类似于脾脏改变的囊壁。然而一些缺乏囊壁或囊壁菲薄的病变术前诊断困难,需要病理确诊。
Objective To retrospectively analyze the clinical and radiographic findings of intraepithelial pancreatic epidermoid cyst (ECIPAS) and to improve its understanding and diagnosis. Methods The clinical features, CT and MRI findings of 5 cases of pancreatic splenic epidermoid cyst proved by operation and pathology were collected. The imaging features included location, size, calcification, cystic characteristics and density Signal) and enhanced features. Results All the 5 patients were female. All of them were detected by physical examination and 3 cases were elevated with CA19-9. Line CT examination in 4 cases, line MRI examination in 3 cases. 5 cases occurred in the tail of the tail, one case of spleen and demarcation between the unclear; long axis diameter of 2.0 to 5.5 cm, an average of 3.4 cm; 3 cases showed multi-capsule, 1 case of single capsule, 1 case was cystic solid ; 3 cases showed solid edge “thick-walled ” density, flat density / signal, multi-phase dynamic enhancement similar to the spleen, given a suggestive diagnosis; 2 cases of thin wall, no obvious peripheral splenic Tissue, of which 1 part of the internal see some of the real component, enhanced scan mild enhancement, preoperative diagnosis of pancreatic cystadenoma and solid pseudopapillary tumor. Conclusions ECIPAS is a very rare disease that occurs in the cystic or cystic solid lesions of the tail of the pancreas. The possibility of ECIPAS should be taken into account. In particular, ECIPAS is found to be similar to the altered wall of the spleen during dynamic contrast-enhanced examinations. However, some lack of cyst wall or thin wall lesions preoperative diagnosis difficult, requiring pathological diagnosis.