胰腺囊性病变的多层螺旋CT表现

目的分析胰腺囊性病变的MSCT表现,探讨MSCT对胰腺囊性病变的诊断价值。方法回顾性分析手术病理或随访证实的56例胰腺囊性病变的MSCT表现。结果 （1）假囊肿18例：单房囊性病灶,10例壁薄,无强化;8例壁厚,均匀线样强化。（2）真囊肿2例,单房囊性病灶,无强化。（3）肠源性囊肿1例,单房囊性病变,壁略厚且有强化。（4）8例浆液性囊腺瘤：2例中央可见星芒状钙化,增强后分隔强化;6例表现为单房囊性病灶,增强后病变无强化。（5）黏液性囊腺瘤5例：2例表现为单房囊性病灶,3例呈多房分隔囊性病灶,增强后壁有强化。（6）囊腺癌5例,肿瘤呈多房分隔囊性病灶,其中4例伴肝脏转移,1例伴邻近血管受侵征象。（7）实性假乳头状瘤10例,3例为囊实混合性,4例以实性为主,3例以囊性为主。其中2例肿瘤有钙化。增强后实性部分门静脉期延时强化;囊性部分无强化。（8）导管内乳头状黏液性肿瘤2例,囊性病变与扩张胰管相通,病灶内可见壁结节。（9）胰腺癌伴囊变4例及胰腺囊性转移瘤1例。结论 MSCT及后处理技术能很好显示胰腺囊性肿瘤内部结构及邻近脏器、血管受累改变,对其诊断及确定手术方案有重要价值。

Imaging features of cytic lesions of the pancreas with multi-slice CT

Objective To analyze MSCT manifestations of cystic lesions of the pancreas and explore MSCT diagnostic value so as to enhance the imaging diagnois of the disease.Methods 56 cases of the CT characteristic of cystic lesions of the pancreas proved by surgery and pathology or follor-up were retrospectively analyzed.Results In 56 cases cystic lesions of the pancreas,unilocular lesion thin walls and non-enhancement in 10 cases,thick walls with uniform thickness after contrast administration in 8 cases was seen in 18 pseucysts.2 cases true cyst was manifested as unilocular lesion and non-enhancement.1 case cyst was characterized by unilocular lesion and line enhancement,8 cases with serous cystadenoma,centrally radial calcification and septa enhancement after contrast administration was seen in 2 cases,unilocular lesion and non-enhancement after contrast administration was seen in 6 cases,5 cases with mucinous cystadenoma,unilocular lesion was seen in 2 cases,multilocular lesions with septa and septa enhancement after contrast injection in 3 cases.5 cystadenocarcinomas were characterized by multilocular lesions with septa,of which multiple intrahepatic metastases was found in 4 cases,and around blood vessels were invaded in 1 cases.10 cases with solid pseudopapillary tumors of pancreas contained similar proportion of solid and cystic part in 3 cases,mostly solid components in 4 cases and mostly cystic components in 3 cases.Calcification can be seen in two cases.After contrast administration,solid part presentedas delaied enhanement during portal vein phase.No enhanement was observed in cyst regions during both phases.In 2 cases with intraductal papillary mucinous tumor,cytic tumors communicated with the dilated pancreatic duct,lesion had mural nodule.4 cases of pancreatic carcnoma with cystic change and 1 case of pancreatic cytic metastatic tumor.Conclusion MSCT can reveal the internal structure of cystic tumors of the pancreas and neighbour involved organ and blood vessel change and play an important role in the treatment of this disease.