胰腺导管内乳头状黏液性肿瘤的MRI诊断

MRI Diagnosis of Intraductal Papillary Mucinous Tumor of the Pancreas

目的探讨胰腺导管内乳头状黏液性肿瘤的MRI表现特点及诊断价值。资料与方法回顾性分析经手术病理证实的10例胰腺导管内乳头状黏液性肿瘤的MRI表现。结果(1)主胰管型3例,分别为导管内乳头状黏液腺癌、腺瘤癌变和腺瘤;MRI表现为主胰管弥漫性扩张,扩张的主胰管内见实性成分的壁结节。(2)6例分支胰管型,除1例为导管内乳头状黏液腺瘤伴不典型增生外,其余均为腺瘤;MRI表现为与主胰管相通的胰腺内囊性病灶,囊性病灶多呈"葡萄"样外观,其内可见索条形分隔及乳头状突起的壁结节。(3)混合型1例,MRI表现为主胰管及分支胰管内乳头状黏液腺瘤。结论MRI在胰腺导管内乳头状黏液性肿瘤的诊断中具有重要作用。

Objective To analyze MR manifestation of intraductal papillary mucinous tumor（IPMT） of the pancreas, and to investigate its diagnostic value. Materials and Methods MRI features of 10 cases with pathologically proved IPMT were analyzed retrospectively. Results （ 1 ） 3 cases of main duct type pancreatic IPMT, including intraductal papillary mucinous adenocarcinoma, the adenoma cancerization and the adenoma respectively. The MRI findings were diffuse dilatation of pancreatic main duct with mural nodules in the expansion main duct, （2） 6 cases of branch duct type pancreatic IPMT, 1 case was intraductal papillary mucinous adenoma with atypical proliferation, the others were the adenomas. The MRI features were cystic lesion with septa and mural nodules in the duct. The cystic lesion with the grape appearance, which was interlinked with the pancreatic main duct, （ 3 ） In 1 case with mixed type pancreatic IPMT displayed dilatation of pancreatic main and branch duct combined with pancreatic papillary mucinous adenoma. Conclusion MRI should be the first choice for diagnosis of IPMT.