胰管内黏液乳头状瘤的MSCT和MRCP表现

Multi-slice CT and MR Cholangio-pancreatographic Findings of Intraductal Papillary Mucinous Tumor of the Pancreas

目的:探讨胰管内黏液乳头状瘤(IPMT)的MSCT和MRCP表现特征。方法:对8例经临床或病理证实的IPMT患者的临床、实验室、影像、病理资料进行回顾性分析。结果:8例患者中,病变位于胰腺钩突部2例、头部1例、体部1例、尾部2例、多发胰管受累2例。症状多为慢性上腹痛。影像表现为分支胰管或主胰管扩张,呈单囊或多囊状,囊内有附壁结节、黏液栓子或分隔,病灶与主胰管相通,主胰管不同程度扩张,十二指肠乳头膨大。ERCP确诊IPMT5例,手术后病理确诊3例,其中腺瘤、交界瘤、腺癌各1例。结论:胰管内黏液乳头状瘤的MSCT和MRCP表现有一定的特征性,结合其临床特征,可以作出正确诊断。

Objective： To study the multi-slice CT （MSCT） and magnetic resonance cholangio-pancreatography （MRCP） features of intraductal papillary mucinous tumor （IPMT） of the pancreas. Methods： The clinical and laboratory materials,imaging features and pathological findings of 8 cases with IPMT were reviewed retrospectively. Results：The location of IPMT of pancreas was as follows： uncinate process （2 cases）, head and body for 1 case each, tail （2 cases） and involvement of multiple pancreatic ducts （2 cases）. The clinical symptom commonly seen was chronic upper abdominal pain. The imaging features included solitary or multiple cystic dilatation of main pancreatic duct （MPD） and the branches,intracystic mural nodule,mucous plug or septation,communication between the focal lesion and MPD,dilation of the MPD with various degree and bulging of the duodenal papilla. 5 cases were confirmed by ERCP and 3 cases underwent surgery,the pathology diagnosis of these 3 cases were adenoma,adenocarcinoma and borderline tumor for 1 case each. Conclusion：Characteristic features of IPMT could be assessed by MSCT and MRCP, correct clinical diagnosis could be obtained when the imaging features were correlated with the clinical materials.