胰腺实性浆液性囊性肿瘤的CT与MRI特征

CT and MRI features of solid serous cystic neoplasm of the pancreas

目的:探讨胰腺实性浆液性囊性肿瘤的特征性影像表现,提高诊断符合率。方法:回顾性分析21例经病理证实的胰腺实性浆液性囊性肿瘤的临床和影像表现。结果:21例胰腺实性浆液性囊性肿瘤中,位于胰头部8例,体尾部13例。病灶形态呈分叶状7例,类圆形14例,边界清晰。肿块平均直径为(29.5±11.0)mm。6例可见钙化,3例上游胰管扩张。21例术前影像诊断全部误诊为其他实性肿瘤。胰腺实性浆液性囊性肿瘤CT平扫呈等或稍低密度,MRI呈T1WI稍低信号,T2WI明显水样高信号,CT及MRI增强扫描均呈明显强化。结论:胰腺实性浆液性囊性肿瘤CT难以诊断,MRI的T2WI水样高信号是最具特征性的影像表现,对诊断及鉴别具有重要作用。

Objective:To investigate the imaging features of solid serous cystic neoplasm(SCN)of the pancreas in order to improve the diagnostic accuracy of the disease.Methods:Retrospective analysis of clinical manifestations and CT and MRI features in 21 cases with pathologically confirmed pancreatic solid SCN.Results:Of the 21 solid SCN,8 cases were located in the head of the pancreas,13 cases were located in the body and tail of pancreas.All tumor showed clear boundary,among which,7 cases were lobulated and 14 cases were round.The mean diameter of the tumor was(29.5±11.0)mm.6 cases with calcification and 3 cases with distal pancreatic duct dilatation.All 21 cases of preoperative imaging diagnostic were misdiagnosed as other solid tumors.The tumor was equal or slightly lower density on non-contrast CT,significantly enhanced after enhancement.MRI showed a slightly lower signal on T1WI,high and water-like signal on T2WI,also significantly enhanced after enhancement.Conclusion:The solid SCN of the pancreas is difficult to diagnosis by CT.The most characteristic imaging feature is high and water-like signal on T2WI of MRI,which plays an important role in diagnosis and differential diagnosis.