31例胰腺导管内乳头状黏液性肿瘤的影像学表现临床观察

Clinical observation of imaging manifestations of 31 cases of intraductal papillary mucinous neoplasm of the pancreas

[背景]观察胰腺导管内乳头状黏液性肿瘤(IPMN)的影像学表现.[病例报告]回顾性分析经病理检查证实为IPMN的31例患者CT,MRI及ERCP检查影像资料.31例IPMN中主胰管型IPMN 8例(25.8%),病灶位于主胰管(MPD),表现为MPD扩张,直径约为2~30mm,多数管腔内可见壁结节,增强呈中等强化;分支胰管型IPMN 12例(38.7%),病灶位于分支胰管(BPD),呈单发或多发囊状扩张,均与MPD相通,囊内未见明显壁结节;混合型IPMN 11例(35.5%),MPD和BPD均见明显扩张,MRCP检查示BPD与MPD相通,且病灶附近胰管明显狭窄或截断.[讨论]IPMN的影像学表现具有一定的特异性,它在IPMN的诊断、分型及鉴别诊断中具有重要价值.

BACKGROUND To observe the imaging manifestations of intraductal papillary mucinous neoplasm（IPMN）of the pancreas.CASE REOPORTS Imaging data of CT,MRI and ERCP（endoscopic retrograde cholangiopancreatography）of 31 patients with pathologically proved IPMN were analyzed retrospectively.Among the 31 cases,8 cases（25.8%）were main pancreatic duct（MPD）type,the lesions were located in the dilated MPD（2-30 mm in diameter）,most lumens of MPD had mural nodules which were moderately strengthened.12 cases（38.7%）were branch pancreatic duct（BPD）type,the lesions were located in the BPD with a single or multiple cystic expansion,which connected with the MPD,and no obvious mural nodules were seen.11 cases（35.5%）were mixed type with dilated MPD and BPD,MRCP showed that the BPD was connected with MPD,and the ducts around the lesions showed distinct stenosis or truncation.DISCUSSION Imaging manifestations of IPMN had definite specificity,and they had important value in diagnosis,classification and differential diagnosis of IPMN.