目的:探讨胰腺实性假乳头状肿瘤（pSPN）的CT表现对其侵袭性行为的预测价值。方法:回顾性分析2009年6月至2019年6月复旦大学附属中山医院经手术切除及病理学证实的103例胰腺实性假乳头状肿瘤患者的临床资料及CT资料，根据手术病理结果将肿瘤分为两组，侵袭组38例，无侵袭组65例，均为单发病灶，对两组病灶的部位、数目、大小、形状、边界，包膜、钙化、出血等进行分析，测量两组病灶实性成分平扫、增强动脉期、增强静脉期的密度，计算增强动脉期、静脉期的强化程度以及增强静脉期与动脉期的强化程度差异，比较两组间差异有无统计学意义。定量指标的比较采用独立样本n t检验，定性指标的比较采用χ2检验或Fisher确切概率法。使用绘制受试者操作特征（ROC）曲线评价动脉期密度、静脉期密度、动脉期强化程度、静脉期强化程度对pSPN的侵袭性行为的预测价值。n 结果:侵袭组和无侵袭组肿瘤的包膜、囊实性组成方面差异具有统计学意义（n P0.05）。侵袭组pSPN的静脉期密度［（76.65±16.71）HU］及静脉期强化程度［（41.04±17.02）HU］均比无侵袭组高［分别为（70.09±12.02）、（34.55±11.41）HU］，且差异均具有统计学意义（n P0.05）。动脉期密度、静脉期密度、动脉期强化程度、静脉期强化程度的ROC曲线下面积分别为0.598、0.634、0.613、0.617，其中只有静脉期密度具有判别效能，最佳临界值为78.65 HU。n 结论:胰腺实性假乳头状肿瘤边界不清，以实性成分为主，肿瘤实性成分静脉期强化明显等征象提示肿瘤具有侵袭性行为。“,”Objective:To investigate CT imaging appearance of pancreatic solid pseudopapillary neoplasm (pSPN) in predicting pathological invasive behaviors.Methods:The clinical data and CT data of 103 patients with solid pseudopapillary neoplasm confirmed by surgical resection and pathology were retrospectively analyzed. According to the pathological results, all cases were divided into two groups: invasive group with 38 cases and non-invasive group with 65 cases. All 103 cases of pSPN had a single lesion. Image analysis included tumor location, size, shape, capsule,calcification, hemorrhage and proportion of cystic or solid component, etc. The density of solid components in all lesions was measured in plain scan, arterial phase and venous phase of CT images. Enhancement degree in arterial phase, enhancement degree in venous phase and enhancement degree between venous phase and arterial phase were calculated, and the differences between the two groups were statistically analyzed. For data analysis, the comparison of continuous variables between two groups was done with Student′s n t-test. Categorical variables were tested using the χn 2 test or Fisher′s exact test. Diagnostic accuracy of density in arterial phase, density in venous phase, enhancement degree in arterial phase and enhancement degree in venous phase were assessed as the area under the receiver-operating characteristic (ROC) curve.n Results:There were statistically significant differences in tumor capsule and proportion of cystic or solid component between the two groups (n P0.05). The density[(76.65±16.71) HU] and enhancement degree[(41.04±17.02) HU] in venous phase in invasive group were higher than those in non-invasive group [respectively (70.09±12.02),(34.55±11.41) HU] and the differences were statistically significant (n P0.05). The area under the ROC curve of density in arterial phase, density in venous phase, enhancement degree in arterial phase and enhancement degree in venous phase were respectively 0.598, 0.634, 0.613, and 0.617, among which only density in venous phase had the discriminant efficacy, and the optimal critical value was 78.65 HU.n Conclusion:The pSPN has no capsule or incomplete capsule, more solid components, and obvious enhancement of the solid components in the tumor in venous phase may suggest that the tumor has more invasive behavior.