影像学诊断在胰腺导管内乳头状黏液性肿瘤中的应用价值

Application value of imaging diagnosis in intraductal papillary mucinous neoplasm

目的探讨影像学诊断在胰腺导管内乳头状黏液性肿瘤(IPMN)中的应用。方法回顾性分析55例IPMN患者的临床资料、影像学及病理资料,分析影像学在IPMN良恶性鉴别中的诊断价值。结果 55例患者中,分支胰管型(BD-IPMN)36例,主胰管型(MD-IPMN)14例,混合胰管型(MT-IPMN)5例。良恶性BD-IPMN患者的壁结节或囊内实性成分、壁结节或囊内实性成分强化、主胰管(MPD)直径、囊壁增厚或强化以及胆管扩张差异有统计学意义(P<0.05或P<0.01),良恶性MD-IPMN及MT-IPMN患者的壁结节或囊内实性成分强化以及MPD直径的差异有统计学意义(P<0.05)。影像学诊断BD-IPMN良恶性的灵敏度为87.5%,特异度为71.4%,准确率为75.5%;诊断MD-IPMN和MT-IPMN良恶性的灵敏度为90.9%,特异度为62.5%,准确率为78.9%。结论影像学对不同分型IPMN良恶性鉴别有较高的诊断价值。

Objective To investigate the application value of imaging diagnosis in intraductal papillary mucinous neoplasm（IPMN）.Methods The clinical and imaging data and pathological files of 55 IPMN patients were retrospectively analyzed.The diagnostic value of imaging for differentiation of benign and malignant was analyzed as well.Results Of 55 cases,36 cases were with branch duct type（BD-IPMN）,14 cases were with main duct type（MD-IPMN）and 5 cases were with mixed pancreatic duct type（MT-IPMN）.The mural nodules or cystic parenchymal components reinforced,main pancreatic duct diameter,capsule wall thickening or reinforced and cholangiectasis were different between benign and malignant BD-IPMN patients（P〈0.05 or P〈0.01）.The mural nodules or cystic parenchymal components reinforced and main pancreatic duct diameter were different between benign and malignant MD-IPMN and MT-IPMN patients（P〈0.05）.The sensitivity,specificity and accurity were 87.5%,71.4% and 75.5% for the imaging to diagnose BD-IPMN.The sensitivity,specificity and accurity were 90.9%,62.5% and 78.9% for the imaging to diagnose MD-IPMN and MT-IPMN.Conclusion Imaging has higher diagnostic value in the differentiation of benign and malignant of different types of IPMN.