具有囊性特征的胰腺导管腺癌与囊腺瘤的多层螺旋CT对比研究

The Comparative Study of Multi-slice Spiral CT(MSCT) in the Differential Diagnosis of Pancreatic Ductal Adenocarcinoma with Cystic Features and Cystadenoma

目的:探讨多层螺旋CT对具有囊性特征的胰腺导管腺癌与胰腺囊腺瘤的鉴别诊断价值。方法:回顾性分析具有囊性特征的胰腺导管腺癌与胰腺囊腺瘤的48例患者的临床资料,均行胰腺CT扫描且经过病理证实。其中胰腺导管腺癌12例、浆液性囊腺瘤16例、黏液性囊腺瘤20例。分析肿瘤位置、单(多)囊、最大囊直径、形态、囊内容物、囊壁特征、囊内分隔、胰管扩张、胰腺萎缩等影像学征象。结果:同时满足4项CT征象(包括形态不规则,囊肿多发,有壁结节,囊壁局部增厚)对于鉴别具有囊性特征的胰腺导管腺癌和囊腺瘤具有较高的敏感度(88%)和特异度(74%)。其他CT表现如囊肿的位置、大小、分隔、胰腺萎缩、淋巴结肿大等对病灶的鉴别诊断无统计学意义(P>0.05)。结论:4项CT征象:形态不规则、囊肿多发、有壁结节、囊壁局部增厚对于鉴别具有囊性特征的胰腺导管腺癌和囊腺瘤具有较高的诊断价值。

Objective：To investigate the value of MSCT in differentiating pancreatic ductal adenocarcinoma with cystic features from pancreatic cystadenoma.Method：CT imaging of 48 patients with pancreatic ductal adenocarcinoma with cystic features were retrospectively analyzed,including 12 patients with pancreatic ductal adenocarcinoma with cystic features,16 patients with serous cystadenoma and 20 patients with mucinous cystadenoma underwent pancreatic. All of the cases were validated with pathological proof. The Tumor location ,the number of cysts（polycystic or not）,diameter of the largest cyst,shape,and contents of cysts were reviewed,in addition to the features of the cystic wall,septa,and other signs of pancreatic and peripancreatic involvement.Result：A combination of the CT findings including irregular contour, multiple cysts,mural nodes,and localized thickening;and had a relatively high sensitivity（88%）and specificity（74%） for differentiating pancreatic ductal adenocarcinoma with cystic features from cystadenoma. Other CT findings such as location,diameter,or the presence of calcification were not significantly different.Conclusion：A combination of the CT findings including irregular contour,multiple cysts,mural nodes,and localized thickening,is highly valuable for differentiation from pancreatic cystadenoma.