胰腺常见囊性肿瘤的影像表现特征及其鉴别诊断

Imaging features and differential diagnosis of common cystic tumors of pancreas

目的探讨胰腺常见囊性肿瘤的MSCT和MRI表现特征及其鉴别诊断要点。方法回顾性分析经手术病理证实的41例胰腺囊性肿瘤[浆液性囊性肿瘤(SCN)10例,黏液性囊性肿瘤(MCN)14例,导管内乳头状黏液性肿瘤(IPMN)17例]的MSCT和MRI表现。结果 SCN中浆液性微囊性腺瘤7例,呈分叶状,囊小而多,多具有中心瘢痕;浆液性寡囊性腺瘤2例,1例单房、1例多房,囊大而少,边缘分叶;实性浆液性腺瘤1例,CT增强检查明显强化,但T2WI可显示其囊性特征。MCN囊大而少,边缘多光滑。IPMN与胰管相通,单房者多表现为杵状指样的囊,多房者囊常呈多种形态。IPMN胰管可出现远端、近端或全程扩张,而SCN和MCN仅近端扩张。结论胰腺常见囊性肿瘤中囊的不同形态对鉴别诊断有提示作用。全程或远端胰管扩张只见于IPMN。

Objective To investigate the imaging features and differential diagnosis points of common cystic tumors of the pancreas on MSCT and MRI.Methods All imaging data of 41 patients（10 serous cystic neoplasms ,14 mucinous cystic neoplasms ,17 intraductal papillary mucinous neoplasms ） confirmed by surgery and pathology were retrospectively analyzed.Results Seven serous microcystadenomas manifested as honeycomb masses with small and numerous cysts,lobulated contour,fibrous central scar.Two serous oligocystadenomas（1 unilocular and 1 multilocular） showed as masses with large and less cysts,lobulated contour.One solid serous adenoma markedly enhanced on CT,while T2WI revealed the cystic features.MCN manifested as masses with large and less cysts and smooth contour.IPMN were communicated with pancreatic duct,showed clubbed fingerlike cysts in unilocular and pleomorphic in multilocular.IPMN showed proximal,distal or whole pancreatic duct dilatation,while SCN and MCN only showed proximal dilatation.Conclusion Different shapes of cysts are helpful to differential diagnosis of common cystic tumors of pancreas.Distal and whole pancreatic duct dilatation only occur in IPMN.