Abstract:
Abstract Objective: To investigate the computed tomographic ( CT ) appearance and characteristics of solid pseudopapillary tumors of the pancreas (SPTP) to improve the accuracy of preoperative diagnosis and to provide a reference for surgical operation and prognostic evaluation. Methods: Data from 20 pathologically confirmed cases of pancreatic solid pseudopapillary tumors 18 females and 2 males, with an age range of 12-73 years and a mean age of ( 30.3 ± 16.2 ) years were retrospectively analyzed. The plain CT scan and multi-phase dynamic CT contrast enhancement were conducted in all cases. The CT appearance of these cases were studied and used for comparative analysis with the surgical operation. Results: Under plain CT, the pancreatic tumors were relatively bigger in the 20 cases, 13 of which showed tumors that overtly extruded from the pancreas. The tumors presented a round, oval, or lobular shape with well- defined edges. Among all cases, 13 presented cystic-solid tumors, 3 were cystic, and 4 were solid tumors. Calcification was found in 9 of the cases. Up to 14 of the total tumors were located in the head of the pancreas, 4 of which showed slight dilatation of the major pancreatic duct, one case manifested expansion and 14 cases did not present any cholangiectasis. Liver metastasis was found in one of these cases. CT contrast enhancement, showed a strengthened imaging of the cystic wall and septa in 3 cystic tumors. The plain CT scan for the solid part of 17 solid and cystic-solid tumors showed isodense or relatively low-density areas. All of them were strengthened after contrast enhancement. The degree of arterial phase enhancement was relatively low, with an average CT value of ( 51.45 ± 10.63 ) HU. The enhancement during the portal venous phase and the parenchymal phase increased significantly compared with the arterial phase, with an average CT value of approximately ( 82.05 ± 22.04 ) HU and ( 81.83 ± 19.86 ) HU, respectively. Statistically significant differences were found in the different figures between the arterial phase and the average CT value ( t1 = -7.34, P = 0.000 and t2 = -7.36, P = 0.000 ), whereas no difference was observed between the portal venous phase and the parenchymal phase ( t3 = -0.15, P = 0.880 ). All 20 tumor patients, including those with liver metastases, underwent surgical excision. Conclusion: Considering parameters such as age, gender, and other related clinical manifestations, the CT scan can be used as an effective tool for accurately diagnosing SPTP. Given that most of Solid pseudopapillary tumors of the pancreas are of low malignancy or are benign, surgical excision is adoptable for almost all cases. Keywords Solid pseudopapillary tumors of the pancreas; X-ray; CT; Surgery