胰腺及胰周囊性病变的影像学鉴别诊断

Imaging Differential Diagnosis of Pancreatic and Peripancreatic Cystic Lesions

目的探讨胰腺及胰周囊性病变的CT及MRI特征,为提高其鉴别诊断水平提供参考。资料与方法回顾性分析34例胰腺囊性病变及14例胰周囊性病变患者的临床及影像学资料,比较病变与胰腺夹角、病变最大直径位置、有无”蛇吞蛋”征、胰管扩张以及胰腺走行改变等影像学特征在不同组织来源间的差异。结果34例患者中,胰腺病变患者病变与胰腺夹角为钝角的比例、最大直径在胰腺内比例、“蛇吞蛋”征出现率以及病变中胰管扩张发生率均高于胰周病变,差异均有统计学意义(P<0.05);胰腺病变中胰腺走行改变10例,胰周病变中胰腺走行改变8例,两者差异无统计学意义(χ2=3.25,P=0.071)。结论胰腺病变与胰腺夹角、胰腺“蛇吞蛋”征、胰管扩张、病变最大直径位置等影像学特征可作为胰腺及胰周囊性病变鉴别诊断的参考因素。

Purpose To discuss the CT and MRI features of pancreatic and peripancreatic cystic lesions, and to provide reference for improving the differential diagnosis of this disease. Materials and Methods A retrospective analysis was performed on the clinical and imaging data of 34 patients with pancreatic cystic lesions and 14 patients with peripancreatic cystic lesions, and the comparison included the angle between the lesion and the pancreas, the position of maximum lesion diameter, the presence or absence of "snake-eggswallowing" sign, the dilatation of the pancreatic duct, the change of the pancreas course, and the difference of imaging characteristics among different tissue sources. Results For 34 patients, the proportion of obtuse angle between the lesion and the pancreas, the proportion of maximum diameter in the pancreas, the incidence of "snake-egg-swallowing" sign and the incidence of pancreatic duct dilation in the lesion of patients with pancreatic lesions were all higher than those of patients with peripancreatic lesions, and the differences were statistically significant (P<0.05). In addition, there were no statistically significant differences between 10 cases of the pancreatic course change in pancreatic lesions and 8 cases of pancreatic course change in peripancreatic lesions (χ2=3.25, P=0.071). Conclusion The imaging features of the angle between the lesion and the pancreas, the "snake-egg-swallowing" sign of the pancreas, the dilation of the pancreatic duct and the position of maximum lesion diameter could be as the reference factors for the identification and diagnosis of pancreatic and peripancreatic cystic lesions.