胰腺导管内乳头状黏液性肿瘤的MRI诊断

MRI Diagnosis of Intraductal Papillary Mucinous Neoplasms of the Pancreas

目的探讨MRI诊断胰腺导管内乳头状黏液性肿瘤(IPMN)的价值。方法7例IPMN患者均行MRI检查。结果7例IPMN患者中,混合型4例,其中3例位于胰头或钩突部,主胰管及分支胰管均有不同程度扩张,1例同时伴有胰体部分支胰管扩张,扩张的主胰管直径为4～8mm;2例十二指肠乳头增大突入肠腔,2例伴有胰体尾部萎缩。分支胰管型3例,均位于胰头和钩突。MRI主要表现为分叶状或葡萄串样囊性病变,其间可见分隔;增强后囊性区域无强化,囊壁和分隔可强化。病灶直径为2.3～7.9cm。结论MRI对IPMN有较重要的诊断价值。

Objective To explore the MRI value in the diagnosis of intraductal papillary mucinous neoplasms（IPMN）of the pancreas.Methods MRI was peformed in all seven patients with IPMN.Results The IPMN（n=7）can be classified into two types based on MRI image：the combined IPMN（n=4）involved branch ducts as well as the main pancreatic ducts with diffent extent dilatation（diameter：4 to 8 mm）,the tumors localized in the head and uncinate process of the pancreas was seen in 3 of the 4 cases,expect one case involoved branch ducts along the pancreatic body;abnormal protruding papilla of vater was seen in two of these and atrophy of the pancreatic body and tail in two cases.The branch duct IPMN（n=3）originated from the head and uncinate process of the pancreas.The tumor consisted of lobulated or clustered small cyst lesions with septa among them,the wall and septa can be enhanced.The diameter arranged from 2.3 to 7.9 cm.Conclusion MRI and is very helpful to the diagnosis of IPMN of the pancreas.