胰腺囊性肿瘤的影像诊断及其鉴别诊断

Imaging Diagnosis and Differential Diagnosis of Pancreatic Cystic Neoplasms

目的探讨胰腺囊性肿瘤的CT和MRI影像学表现及其鉴别诊断要点。方法回顾性分析经手术病理证实的胰腺囊性肿瘤44例。结果 (1)黏液性囊腺瘤(MCN)17例,位于胰腺体尾部11例,多表现为大囊性病灶,边界清楚,部分可见壁结节及分隔,平均直径约73.0mm,6例发生恶变;(2)浆液性囊腺瘤(SCN)11例,年龄在48~73岁,微囊型8例,其中5例表现为放射状排列间隔,寡囊型2例,实性浆液性囊腺瘤1例;(3)导管内乳头状瘤(IPMN)8例,男性6例(75%),平均年龄55岁,分支胰管型5例,主胰管型3例,所有病灶均与胰管相通,7例出现不同程度的胰管扩张;(4)胰腺实性假乳头状瘤(SPN)8例,均为女性,平均年龄29岁,均为囊实性病变,其中5例病变有出血。结论本文通过分析胰腺囊性肿瘤CT和MRI影像特点及鉴别要点,以提高该病的术前影像诊断。

Objective To investigate the CT and MRI imaging features of pancreatic cystic neoplasms. Methods All imaging date of 44 patients（pancreatic cystic neoplasms） confirmed by surgery and pathology were retrospective analyzed. Results（1）Mucinous cystic neoplasms（MCN） 17 cases, 11 cases located in the body and tail of pancreatic, manifested clear boundaries, capsule visible wall nodules and partitions.MCN usually large volume, mean diameter 73.0 mm.There are 6 cases of MCN were malignant.（2）Serous cystic neoplasms（SCN） 11 cases.SCN were usual Iy lobular with many sma Il cysts. Microcystadenomas in 8 cases, of which 5 cases showed radiating fibrous septation. 2 cases of Oligocystic cystadenomas, solid serous cystadenoma in 1 case.（3）Intmductal papillary mucinous neoplasm（IPMN）8 cases, have 6 males and 2 females with an average age of 55 years, 3 of them were main-duct type and 5 of them were branch-type.All lesions were communicated with the pancreatic duct, and different degrees of pancreatic duct dilatation occurred in 7 cases.（4）Solid pseudopapillary neoplasms（SPN） 8 cases, the average age of 29 years old,are all women and all cystic solid lesions and 5 of them bleeding. Conclusion This paper analyzes the CT and MRI features of pancreatic cystic tumors and their differential diagnosis, which was helpful to the preoperative diagnosis of pancreatic cystic tumors.