胰腺导管内乳头状黏液性肿瘤CT、MRI影像学特征及临床诊治价值分析

CT and MRI Imaging Features of Intraductalpapillary Mucinous Tumors of the Pancreas to Provide Relevant Data for Clinical Diagnosis and Treatment

目的通过分析胰腺导管内乳头状黏液性肿瘤CT、MRI影像学特征,为临床诊治提供相关资料。方法选取我院2017年4月至2019年4月收治的胰腺导管内乳头状黏液性肿瘤(IPMT)患者31例,31例患者均进行CT及MRI检查,总结良、恶性IPMT患者不同影像学特征,如主胰管的扩张程度、胰腺实质囊性病变的直径、有无附壁结节及其直径。结果(1)CT与MRI对31例IPMT患者鉴别诊断符合率比较无差异(93.54%vs 100.00%)(P﹥0.05)。(2)15例良性IPMT患者CT平扫主胰管管径扩张范围:(5.63±2.18)mm;增强扫描中,4例(26.66%)患者出现扩张的主胰管内,MRI平扫可见多房囊状肿瘤,信号特点为长T_(1)、长T_(2)。(3)恶性IPMT中10例为主胰管型,分支胰管型6例;CT平扫显示主胰管局限性扩张型9例,弥漫性扩张型7例,平均扩张(16.72±4.12)mm,MRI上恶性IPMT形态单房或多房囊状肿瘤,于其肿瘤内部可见充盈缺损壁结节,增强扫描后呈现轻-中度强化,31.25%恶性IPMT可见胰腺周围可见肿大转移淋巴结。结论MRI、CT检查均可有效显示良、恶性IPMT影像学特征,根据影像学表现可有效鉴别其性质,为治疗提供可靠的依据。

Objective To analyze the CT and MRI imaging features of intraductalpapillary mucinous tumors of the pancreas to provide relevant data for clinical diagnosis and treatment.Method 31 patients with intraductalpapillary mucinous tumors(IPMT)treated in our hospital from April 2017 to April 2019were selected.All 31 patients were examined by CT and MRI.The different imaging features such as the degree of expansion in the main pancreatic duct,the diameter of parenchymal cystic lesions,the presence or absence of mural nodules and the diameter between patients with benign or malignant IPMT were summarized.Results(1)There was no difference in the diagnostic accuracy between CT and MRI in 31 patients with IPMT(93.54%vs 100.00%)(P﹥0.05).(2)In the plain CT scan of 15patients with benign IPMT,the range of the expansion diameter of the was(5.63±2.18)mm.And in the enhanced scan,in dilated main pancreatic duct of 4 patients(26.66%),MRI plain scan showed a multilocular cystic tumor,and signal characteristics are long T_(1) and long T_(2).(3)Among the malignant IPMT,there were 10 cases with expansion in the main pancreatic duct,6 cases with expansion in the branch of pancreatic duct.CT scan showed localized dilatation of pancreatic ducts in 9 cases and diffuse dilatation in 7 cases,with average expansion(16.72±4.12)mm.MRI showed that malignant IPMT was unilocular or multilocular cystic tumor.Wall nodules of filling defect can be seen inside the tumor,and light-to-moderate enhancement can be seen after enhanced scanning.31.25%of malignant IPMT showed enlarged lymph nodes around the pancreas.Conclusion MRI and CT examinations can effectively display the benign and malignant IPMT imaging features,and can effectively identify their properties based on the imaging findings,which can provide a reliable basis for treatment.