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目的探讨三期螺旋CT扫描在小胰岛细胞瘤(直径≤2cm)诊断中的价值。资料与方法回顾性分析经病理证实的12例小胰岛细胞瘤患者的螺旋CT平扫及三期螺旋CT检查表现。结果12例患者共发现13个胰岛细胞瘤,其中胃泌素瘤1个,胰岛素瘤11个,无功能胰岛细胞瘤1个。CT平扫仅发现少数病灶(1/13),三期螺旋CT检查发现绝大多数病灶(12/13)。7个病灶强化峰值出现在动脉期,6个病灶强化峰值出现在实质期。病灶CT值动脉期为(118.0±31.6)HU,实质期为(131.2±26.6)HU,门静脉期为(104.5±16.3)HU,实质期与门静脉期之间有统计学意义(P<0.05),动脉期与门静脉期之间无统计学意义(P>0.05)。所有的病灶在三期增强CT上均表现为中等度或明显强化。11个病灶表现为明显均匀强化,2个病灶表现为环形强化。1个非功能性胰岛细胞瘤螺旋CT表现与其余12个功能性胰岛细胞瘤无明显差别。结论小胰岛细胞瘤三期扫描均呈中等度或明显强化,大部分表现为均匀强化,动脉期和胰腺实质期能够检出绝大部分小胰岛细胞瘤;螺旋CT增强三期扫描对判断小胰岛细胞瘤是否具有功能性价值有限。
Objective To investigate the value of three-phase spiral CT in the diagnosis of small islet cell tumor (diameter≤2cm). Materials and Methods Retrospective analysis of pathologically confirmed 12 cases of isletscell tumor of small pancreatic islet spiral CT and triple helical CT examination. Results A total of 13 islet cell tumors were found in 12 patients, including 1 gastrinoma, 11 insulinomas and 1 non-functioning islet cell tumor. Only a few lesions were found by CT plain scan (1/13). The majority of lesions were found by triple helical CT (12/13). Seven lesions enhanced peak appeared in the arterial phase, six lesions enhanced peak appeared in the puberty. The CT value of the lesion was (118.0 ± 31.6) HU, the real period was (131.2 ± 26.6) HU, the portal vein phase was (104.5 ± 16.3) HU, and there was a significant difference between the pus and the portal vein (P <0.05) Arterial and portal venous phase was not statistically significant (P> 0.05). All lesions showed moderate or significant enhancement on stage III CT. Eleven lesions showed markedly uniform enhancement and two lesions showed circular enhancement. Spiral CT findings of one non-functional islet cell tumor showed no significant difference from the other 12 functional islet cell tumors. Conclusions All three islets of small islet cell tumor showed moderate or significant enhancement, most of them showed homogeneous enhancement, most of islet cell tumors were detected in arterial phase and pancreatic parenchyma. Whether a cell tumor has a functional value is limited.