胰腺浆液性囊腺瘤与黏液性囊腺瘤的CT诊断与鉴别

Diagnosis and differential diagnosis of serous or mucinous cystadenoma of the pancreas via CT

目的分析胰腺浆液性囊腺瘤与黏液性囊腺瘤的CT影像学特点,以提高对该病的诊断水平。方法回顾性分析经手术病理证实的胰腺浆液性囊腺瘤16例,黏液性囊腺瘤11例,其中男性5例,女性22例,年龄在30~83岁之间,本组27例行CT平扫并增强扫描,分析病变在CT图像上的位置、大小、形态、密度及肿瘤的强化特点。结果 16例胰腺浆液性囊腺瘤中病灶位于胰头部10例,胰体尾部6例,6例见中央瘢痕,3例见钙化,3例见壁结节,其中1例实性部分较多,病理证实为交界性肿瘤,呈小囊型的8例,大囊型的5例,混合型的3例;11例黏液性囊腺瘤中病灶位于胰颈部的2例,胰体尾部的9例,4例囊壁见钙化,6例见壁结节,单囊3例,多囊8例;增强扫描病灶囊壁、纤维间隔及实性部分强化,囊性部分未见强化。结论胰腺浆液性囊腺瘤与黏液性囊腺瘤的CT表现有一定的特征性,对其诊断及鉴别诊断具有重要的临床价值。

Objective To analyze the CT features of serous cystadenoma and mucinous cystadenoma of the pancreas so as to raise awareness for the diagnosis of those two disorders. Methods 16 patients with pancreatic serous cystadenoma and 11 patients with pancreatic mucinous cystadenoma, who were confirmed pathologically, were retrospectively analyzed in this work. In this co- hort of patients, there were 5 males and 22 females, aged between 30 to 83 years old. All of those 27 patients underwent plain and enhanced CT scan and the location, size, shape, density, and enhancement patterns of lesions in the CT images were analyzed. Results In those 16 cases of pancreatic serous cystadenoma, lesions were located in the pancreatic head in 10 cases of, in the body and tail of the pancreas in 6 cases; Central scar was seen in 6 cases, calcification was found in 3 cases, mural nodule was observed in 3 cases, much more solid component was found in 1 case, which was pathologically determined as a borderline tumor; Small capsule type was found in 8 cases, large cystic type was found in 5 cases, and the mixed type was found in 3 cases. As for those 11 cases of pancreatic mucinous cystadenoma, lesions were located in the neck in 2 eases, in body and tail of the pancreas in 9 cases; wall calcification was seen in 4 cases, mural nodules was observed in 6 cases; single capsule type was found in 3 ca- ses, polycystic type was found in 8 cases ; On the enhanced scan, the cyst, fibrous septa and solid part of lesions were exhibited partial enhancement, whereas, cystic part was shown no enhancement. Conclusion CT manifestations of serous or mucinous cystadenoma of the pancreas have certain characteristics, which has important clinical value to their diagnosis and differential diagnosis.