胰腺导管内乳头状黏液瘤的MRI表现与病理对照

目的探讨胰腺导管内乳头状黏液瘤（IPMN）的MRI表现和诊断价值。方法回顾性分析11例经超声内镜引导下细针穿刺（EUS—FNA）或手术病理证实的胰腺导管内乳头状黏液瘤的MRI表现。MRI扫描包括常规平扫、动态增强以及磁共振胰胆管成像（MRCP）和扩散加权成像（DWI）。测量每个病灶的表观扩散系数（ADC）值，比较高异型性／侵袭性与低异型性IPMN的ADC值。结果主胰管型3例，主胰管弥漫性或节段性扩张，可见附壁结节：分支胰管型5例，呈分叶状或葡萄状扩张；混合型3例，主胰管和分支胰管均有不同程度扩张。高异型性／侵袭性IPMN的ADC值明显低于低异型性IPMN（P=0．03）。结论MRI可以展示胰腺导管内乳头状黏液瘤的病理特征，测量ADC值有助于评估其良恶性。

Imaging features of intraductal papillary mucmoas neoplasm of pancreas with MRh compared with pathology

Objective To evaluate the MR imaging features and Diagnostic value of pancreas intraduetal papillary mucinous neoplasm （IPMN）. Methods MRI findings of a retrospective analysis of 11 cases by endoscopic ultrasound- guided fine-needle aspiration （EUS-FNA） or pathologically confirmed pancreatic intraductal papillary mucinous neoplasm. MRI scan including conventional unenhanced,dynamic contrast-enhanced, magnetic resonance eholaugiopanereatography （MRCP） and diffusion-weighted imaging （DWI）. The apparent diffusion coefficient （ADC） values were measured for each lesion, relatively the ADC values of high-grade or invasive IPMN and low-grade IPMN. Results 3 cases of main duct type, the main pancreatic duct diffuse or segmental dilation, can be seen mural nodules. 5 cases of branch duct type, lobulated or grape-like expansion. 3 cases of mixed type, the main pancreatic duct and branch ducts have different levels of dilation. The ADC values for high-grade or invasive 1PMN were significantly lower than those for low-grade IPMN （P = 0.03）. Conclusion MRI can show pathological features of intraductal papillary mueinous neoplasm and measurements ADC values can help assess it＇ s benign or malignant.