多层螺旋CT诊断胰腺囊性肿瘤的价值

The Value of Multi-Slice CT in Diagnosis of Pancreatic Cystic Tumors

目的:探讨多层螺旋CT(MSCT)诊断胰腺囊性肿瘤的价值。方法:回顾性分析16例于笔者所在医院进行CT检查并经病理证实的胰腺囊性肿瘤患者的多层螺旋CT图像。结果:所有患者中浆液性囊腺瘤5例,4例病灶外形呈分叶状,单房囊性病灶1例,多房囊性病灶4例,囊壁及囊内分隔厚薄均匀,分隔较薄,无壁结节,增强扫描时囊壁与分隔强化,1例可见中央星状瘢痕伴钙化,符合浆液性囊腺瘤CT特征性表现;黏液性囊性肿瘤7例,患者病灶较大,平均直径超过10 cm,3例单房囊性病灶,4例多房囊性病灶,囊内纤维分隔较厚,其中黏液性囊腺瘤4例,多房囊肿,1例较小壁结节,黏液性囊腺癌3例,边界不清,囊壁厚且不均匀,2例可见较大壁结节,1例伴肝转移;实性假乳头状瘤3例,肿瘤包膜较厚,2例包膜完整,1例包膜不完整,1例较大病灶内可见出血灶,1例病灶实质部分可见斑块状钙化,2例囊实性比例相仿病灶,1例以囊性为主的囊实性病灶,增强扫描时实性成分渐进性强化;导管内乳头状黏液性肿瘤1例(分支胰管型),CT表现为葡萄串样囊性肿块与扩张的胰管相通。结论:多层螺旋CT在胰腺囊性肿瘤的诊断及鉴别诊断中有重要临床价值。

Objective： To investigate the value of MSCT in diagnosis of pancreatic cystic tumors.Method： A total of 16 patients with received MSCT scan and pathological diagnosed pancreatic cystic tumors admitted to our hospital were selected and whose MSCT images were analyzed retrospectively.Result： Among all the patients, 5 patients were serous cystadenoma, in which 4 lesions were with lobulated shape, and single cystic lesion was in 1 case, while multiple cystic lesions in 4 cases, the cyst wall and septal were thin and enhanced after contrast medium injected with no cyst nodule.1 lesion presented with a central star-shaped calcified scar, which was a characteristic manifestation; 7 patients were mucinous cystic tumors, the mean diameter was more than 10 cm, of which 3 cases were single cystic lesions, 4 cases were multiple cystic lesions, the cyst wall and septl were thick, 4 cases were muhilocular cyst, and 1 small mural nodules; 3 patients were mucinous cystadenocarcinoma, in which 2 cases presented with ill-defined and inhomogeneous cyst wall, large mural nodules were seen in 2 cases, 1 case complicated with liver metastasis; 3 patients were pseudopapillary solid tumors, the tumor capsules were thick, in which 2 cases were with completed capsules and 1 case was with incomplete capsule, 1 larger lesion appeared hemorrhage, 1 lesion was with plaque calcification in solid portion, 2 cystic lesions were with similar proportion, 1 lesion was mainly cystic, the solid portion were gradually enhanced.1 patient was papillary mucinous neoplasms （branch duct type）, the CT result showed bunch of grapes like cystic mass communicating with the enlarged main pancreatic duct.Conclusion： MSCT has important clinical value in the diagnosis and differential diagnosis of pancreatic cystic tumors.