64排螺旋CT在胰腺囊性病变诊断中的应用价值

Value of 64-Slice Spiral CT in the Diagnosis of Pancreatic Cystic Lesions

目的 观察胰腺囊性病变64排螺旋CT表现,并分析其诊断标准。方法 搜集2020年3月至2023年3月行64排螺旋CT检查的70例胰腺囊性病变患者的临床资料,其中33例经术后病理检查获取诊断结果,8例有穿刺活检病理诊断结果,29例通过临床随访(≥12个月)获取最终的诊断结果。分析所有病变的64排螺旋CT诊断结果及影像学表现。结果 64排螺旋CT对假性囊肿、浆液性囊腺瘤、黏液性囊腺性肿瘤、实性-假乳头状瘤、导管内乳头状黏液瘤的正确诊断率分别为92.86%、81.82%、80.00%、83.33%、80.00%。5种胰腺囊性病变部位、形态、边界、囊壁、分房数目、分隔、壁结节或实性成分、周围改变、钙化、胰管扩张及是否与胰管相通比较,差异均有统计学意义(P<0.05)。浆液性囊腺瘤、黏液性囊腺性肿瘤形态、最大直径、囊壁、分房数目、胰管扩张比较,差异均有统计学意义(P<0.05)。结论 64排螺旋CT可清晰地显示胰腺囊性病变内部结构及与胰管、血管等周围结构的关系,结合临床相关病史,有助于术前准确诊断。

Objective To observe the 64-slice spiral CT manifestations of pancreatic cystic lesions and analyze their diagnostic criteria.Methods The clinical data of 70 patients with pancreatic cystic lesions who underwent 64-slice spiral CT examination from March 2020 to March 2023 were collected,of which 33 cases obtained diagnostic results by postoperative pathological examination,8 cases had puncture biopsy pathological diagnosis results,and 29 cases obtained final diagnosis results by clinical follow-up(≥12 months).The 64-slice spiral CT diagnostic results and imaging findings of all 1esions were recorded.Results The correct diagnosis rates of pseudocysts,serous cystadenomas,mucinous cystadenomas,and solid-pseudopapillary tumors,intraductal papillary mucinous neoplasm by 64-slice spiral CT were 92.86%,81.82%,80.00%,and 83.33%,80.00%, Respectively.There were statistically significant differences in the location,shape,boundary,cyst wall,number of cells,compartments,wall nodules or solid components,peripheral changes,calcification,pancreatic duct dilation,and whether the five cystic lesions were interconnecting with pancreatic ducts(P <0.05).There were significant differences between serous cystadenoma and mucinous cystadenoma in morphology,maximum diameter,cyst wall,cell number and pancreatic duct dilation(P <0.05).Conclusion The internal structure of pancreatic cystic lesions and their relationship with surrounding structures such as pancreatic ducts and blood vessels can be clearly shown by64-slice spiral CT,which is helpful for accurate preoperative diagnosis in combination with clinical history.