胰腺导管内乳头状黏液性肿瘤的多层螺旋CT诊断

MDCT findings of intraductal papillary mucinous neoplasms of the pancreas

目的探讨胰腺导管内乳头状黏液性肿瘤在多层螺旋CT上的影像特点。方法回顾性分析30例经手术切除和病理学证实的胰腺导管内乳头状黏液性肿瘤的临床、多层螺旋CT影像学资料,结合CT血管造影(computed tomography angiography,CTA)、多平面图像重组和二维曲面重组等影像技术观察其影像学表现,分析影像学表现与病理结果的相关性。结果 30例胰腺导管内乳头状黏液性肿瘤的多层螺旋CT诊断:主胰管型13例,分支胰管型9例,混合型8例;术后病理结果显示胰腺导管内乳头状黏液性瘤8例,胰腺交界性或低度恶性乳头状黏液瘤8例,胰腺导管内乳头状黏液癌14例。结论胰腺导管内乳头状黏液性肿瘤具有特征性的影像学表现,螺旋CT能协助诊断并能对其分型,运用CTA、多平面图像重组和二维曲面重组等影像技术有助于术前评估肿瘤的良、恶性。

Objective To evaluate the imaging features of pancreatic intraductal papillary mucinous neoplasms（IPMNs）in multi-detector row computed tomography（MDCT）.Methods A total of 30 patients with histopathologically-confirmed IPMNs were included in this study..Axial MDCT images combined with CT angiography（CTA） and multiplanar volume reformations（MPVR） or curved reformations（CR） were preoperatively acquired.Results Among the total 30 patients with IPMN on MDCT study,13 cases were interpretated as IPMN of the main pancreatic ducts（MPDs）;9 cases as IPMN of the side branches;and 8 as mixed-type IPMN involving both the MPD and the side branches（mixed type）.As the results of histopathologic examination of the surgical specimen,8 of the 30 IPMN were classified as adenomas,8 were classified as border line tumors,14 were classified as carcinomas.Conclusions MDCT with CTA and MPVR or CR techniques is of great value in classifying and elucidating the imaging features of IPMNs and help predict the malignancy of these tumors.