多层螺旋CT对胰腺导管内乳头状黏液性肿瘤的诊断价值

Diagnostic value of multi-slice computed tomography technology for intraductal papillary mucinous neoplasm

目的探讨胰腺导管内乳头状黏液性肿瘤（IPMN）的多层螺旋CT诊断价值。方法分析12例经手术病理证实的IPMN的临床资料及CT图像表现,包括胰管扩张的程度、范围,病灶的大小、形态、密度、边缘和强化方式等。采用曲面重建技术显示扩张的主胰管和分支胰管。结果12例IPMN中,男性8例,女性4例,年龄48~85岁。肿瘤位于钩突部7例,胰腺体部3例,胰腺头部和尾部各1例。分支胰管宽度〉5 mm者10例,主胰管宽度〉5 mm者4例,其中2例表现为胰腺弥漫性肿胀和胰腺实质内肿块。分支胰管型8例,主胰管型3例,混合型1例。病理结果显示腺瘤4例,交界性肿瘤5例,腺癌3例。结论多层螺旋CT对IPMN的诊断、分型具有重要的临床应用价值。

Objective To explore the diagnostic value of intraductal papillary mucinous neoplasm（IPMN） by multi-slice computed tomography（MSCT）.Methods The clinical data and CT findings of 12 cases proved by operation pathology were analyzed,including the dilation degree and ranges of pancreatic duct,size,shape,edge,as well as enhancement.CPR was used to display the dilating main and branch duct.Results Twelve patients with IPMN including 8 men and 4 women,from 48 to 85 years old.Seven lesions located in the uncinate process of pancreas,3 cases in the body of pancreas,the head and tail of pancreas for 1 case each.Ten cases indicated the width of branch pancreatic ducts 5 mm,4 cases indicated the width of main pancreatic ducts5 mm.8 cases were interpreted as IPMN of the side branches,3 cases as IPMN of the main pancreatic duct（MPD）,and 1 case as IPMN of the both MPD and the side branches（the mixed type）.The diagnostic result of pathology shows 4 cases as pancreatic gland neoplasms,5 cases as borderline tumors,and 3 cases as glandular cancers.Conclusion MSCT technology is of great value in IPMN diagnosing and classifying.