胰腺炎性假囊肿和胰腺癌性假囊肿的CT征象对照分析

Contrastive Analysis of CT Signs of Paeudocyst of Pancreatitis and Paeudocyst of Pancreatic Carcinoma

目的探讨胰腺炎性和癌性假性囊肿的不同CT征象。方法收集经手术或临床随访证实的胰腺炎合并假囊肿20例和胰腺癌继发性假囊肿15例,对其CT征象进行回顾性分析。结果炎性假囊肿表现:(1)胰腺巨大囊肿;(2)胰周囊肿伴毗邻组织炎性反应;(3)囊肿大于6cm;(4)有胰腺炎的征象。癌性假囊肿表现:(1)胰头体部肿块;(2)体、尾部小于5cm的囊肿;(3)胰尾萎缩;(4)肝、腹内淋巴结转移。结论CT不可能对所有的胰腺假囊肿作出定性诊断,应对可疑患者尽早做ER-CP、穿刺活检或手术探查,以提高胰腺假性囊肿定性诊断的正确性。

Objective To explore diffent CT signs of paeudocyst of pancreatitis and pancreatic carcinoma. Methods 20 cases of inflammatory and 15 cases of malignant paeudocysts of pancreas by operation or follow-up were included in two groups. The paeudocysts＇ CT manifestations were reviewed and analyzed by reference of document. Results CT signs of inflammatory paeudocyst：（1 ）Huge cystic fluid collection in the pancreas;（2）Extrapancreatic paeudocyst associated with thickening of the gastric wall or Gerota fascia; （3） The size of the paeudocyst larger than 6cm in diameter,（4）Presence of CT signs of acute or chronic pancreatitis. The reliable CT signs for malignancy were： （1）Mass in the head or/and body of the pancreas;（2）The size of the paeudocyst less than 5cm in diameter; （3） Atrophic changes of the tail of the pancreas;（4）Liver and lymph node of abdomen had found tansfer tumor. Conclusion CT can not make diagnosis of determining the all pancreas false cyst, should make ERCP as soon as possible to suspicious patients, puncture examine or operation ascertain, in order to improve pancreas to be getting false cyst to determine the exactness of diagnosis.