| 岳奎涛,刘剑羽,王智勇,李磊,刘从容.胰腺导管内乳头状黏液性肿瘤的MSCT征象[J].中国医学影像技术,2012,28(7):1367~1370 |
| 胰腺导管内乳头状黏液性肿瘤的MSCT征象 |
| MSCT features of intraductal papillary mucinous neoplasm in the pancreas |
| 投稿时间：2012-02-09 修订日期：2012-03-07 |
| DOI： |
| 中文关键词: 胰腺肿瘤 导管内乳头状黏液性肿瘤 体层摄影术,X线计算机 |
| 英文关键词:Pancreatic neoplasms Intraductal papillary mucinous neoplasms Tomography, X-ray computed |
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| 中文摘要: |
| 目的 探讨胰腺导管内乳头状黏液性肿瘤(IPMN)的MSCT特点。方法 回顾性分析27例经病理证实的IPMN的MSCT表现。所有患者均接受16层或64层CT平扫及增强检查,其中7例接受ERCP检查。结果 27例IPMN中,主胰管型11例,包括2例交界性肿瘤,4例原位癌,5例腺癌;CT表现为胰腺不同程度萎缩,主胰管扩张,8例内部可见壁结节,1例见多发斑块状钙化。分支胰管型9例,包括腺瘤和交界性肿瘤各3例,1例原位癌,2例腺癌;其中7例位于胰头部,表现为与主胰管相通的囊性病灶,内见分隔和乳头状壁结节,呈"葡萄串"样,1例可见点状钙化;2例位于胰尾部,呈类圆形囊性病灶,增强无强化。混合型7例,包括交界性肿瘤和腺癌各3例,原位癌1例,表现为主胰管及分支胰管扩张伴腔内壁结节,3例病变内可见不同程度钙化。7例接受ERCP,其中5例明确显示囊性病灶与主胰管相通。结论 IPMN的MSCT表现具有一定特征。MSCT结合ERCP检查有助于术前准确诊断。 |
| 英文摘要: |
| Objective To analyze MSCT features of intraductal papillary mucinous neoplasms (IPMN)of the pancreas. Methods Totally 27 patients with IPMN confirmed by pathology were retrospectively analyzed. All patients underwent plain and contrast-enhance CT, 7 patients underwent ERCP. Results Among the 27 cases, 11 were interpreted as IPMN of the main pancreatic duct (MPD). Two of these 11 MPD were classified as borderline tumors, 4 were carcinomas, and 5 were adenocarcinoma. The atrophy of pancreas at different degrees and obvious dilation of MPD were demonstrated on CT, with solid mural nodules in the duct were seen in 8 cases, while 1 case had pancreatic calcification. Nine cases were interpreted as IPMN of the branch-duct type, 3 were classified as adenomas, 3 were borderline tumors, 1 was carcinomas, and 2 were adenocarcinoma. Among these 9 cases, 7 IPMN located in the pancreas head, displayed as cystic lesions linking to the main duct which shaped like grape string, with some septum and nodules could be seen within the duct, and 1 case had pancreatic calcification, while 2 IPMN located in the pancreas tail, shaped like round and did not enhance after injection of contrast medium. Seven cases were interpreted as IPMN of the mixed type with solitary papillary nodules in the duct wall, together with dilation of the main duct and branches, the cystic lesions linking with the main duct were presented on MSCT, 3 of the 7 mixed type were classified as borderline tumors, 3 were adenocarcinoma, and 1 was carcinoma. Cystic lesion linking with the main duct was found in 5 of 7 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP). Conclusion IPMN has some characteristic MSCT features. MSCT combined with ERCP is helpful to diagnosing IPMN of the pancreas before operation. |
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