25例胰腺胰管内乳头状粘液性肿瘤MRI和ERCP比较研究

The study of MRI findings of 25 cases Intraductal Papillary Mucinous Tumor of the pancreas comparing with ERCP

目的研究胰腺胰管内乳头状粘液性肿瘤的临床特点,MRI影像表现并和ERCP比较。方法自1998年至2001年25例(主胰管型6例,分枝型19例)手术证明的胰管内乳头状粘液性肿瘤患者。手术前所有患者均接受了MRI和ERCP检查,回顾分析了临床特点,MRI和ERCP影像学表现。结果MRI上主胰管型表现为弥漫/节段扩张的主胰管,5例伴有壁结节;分枝型表现为葡萄串状或单发的囊状肿瘤,14例内有壁结节,增强后壁结节明显强化。MRCP可清楚地显示19例分枝型IPMT和主胰管之间的交通。MRI和ERCP对肿瘤的显示率分别是100%,52%。结论与ERCP相比,MRI是一种非侵袭性的有效地诊断胰管内乳头状粘液性肿瘤的方法。MRCP(磁共振胆胰管成像)对分枝型肿瘤的诊断有重要意义。

Objective To study clinical features and MRI findings of Intraductal Papillary Mutinous Tumor（IPMT） of the pancreas comparing with ERCP findings. Methods From 1998 to 2001, twenty-five eases with IPMT who underwent MRI and ERCP before operation were reviewed. IPMT were classified into main duct type（ n = 6） and branch duct type（ n = 19）. We assessed clinical presentation, MRI and ERCP findings. Results Main duct type was found to have dlffuse/part dilatation of main duct with five nmral nodules. Grapes-like or single cystic tumor was found in branch duct type with 14 mural nodules. Mural nodules were strongly enhaneed after contrast medium administration. Conclusion Between the branch duct type and the MPD was demonstrated in 19 patients by MRCP. IPMT were all displayed on MRI, however only 52% tumor were displayed on ERCP. Conclusion Comparing with ERCP, MRI is a noninvasive and useful method to diagnose IPMT. MRCP is valuable for the diagnosis of branch duct type.