成人胰腺真性囊肿的诊断(附八例报告)

成人胰腺真性囊肿的诊断（附八例报告）赵荣国任小波张伟宏秦明伟潘卫东左世和成人胰腺真性囊肿临床上少见，并常常误诊为胰腺假性囊肿或其他囊性肿瘤。笔者报告８例成人胰腺真性囊肿，总结分析其临床及影像学资料，以期提高对本病的认识。材料与方法笔者搜集１９９０年１...     

胰腺囊性病变的CT鉴别诊断

目的 探讨胰腺囊性病变的CT鉴别诊断。资料与方法 回顾性研究17例经手术及病理确诊的胰腺囊性病变的CT影像学特点，结合临床及病理特征，以此作为鉴别诊断的依据。结果 囊腺肿瘤6例，非功能性胰岛细胞肿瘤4例，胰腺癌囊变3例，胰腺癌合并囊肿2例，假性囊肿2例。结论 胰腺囊性病变的CT鉴别诊断须综合判断，除了分析囊壁的形态及分离等CT表现外，还应结合临床资料。     

螺旋CT诊断胰腺假性囊肿价值分析

胰腺假性囊肿（pancreaticpseudo—cysts,PPC）在临床上最常见,约占全部胰腺囊肿的80％,而75％是由于急性胰腺炎引起。10％-20％为胰腺外伤所致。我院曾诊治胰腺假性囊肿46例,术前均经过螺旋CT扫描,进行影像学诊断,能够很好地辅助指导临床治疗,现回顾分析如下。     

胰腺炎并发假性囊肿或积液的CT分型与命名

目的：探讨胰腺炎并发假性囊肿或积液的CT分型与命名，为其诊断及鉴别诊断提供依据。方法：分析我院收治的胰腺炎合并假性囊肿或积液40例的CT影像学特征、发病机制及病理特点，并根据以上特征进行临床分型与命名。结果：以胰腺为主体，由近至远对胰腺炎并发假性囊肿或积液进行分型和命名，可分为胰内型、胰周型、胰内伴胰周型、异位型、胰内伴异位型、胰周伴异位型和胰内胰周伴异位型等7种类型。结论：分型与命名既能反映病源性质，又能确切地反映病变受累范围及CT扫描的特征，有利于诊断及制定有效治疗措施和选择手术时机及方式。     

胰腺囊性病变的影像表现与临床特点（上）

胰腺囊性病变(PCL)是一大类胰腺上皮和间质组织发生囊腔病变的疾病,以胰腺内囊性包块为主要特征,具有不同的病因、临床和组织病理学特点。PCL种类繁多,根据其病因的不同,可分为外伤与炎症相关囊性病变、肿瘤性囊性病变、先天性囊性病变及其他囊性病变。充分认识其影像特征和相关临床特点是诊断与鉴别诊断的基础。影像检查对PCL的诊断和治疗后复查及随访具有重要价值。就胰腺炎症相关囊性病变、胰腺真性囊肿、胰腺囊性肿瘤等囊性病变的影像表现与临床特点予以阐述,以期为临床诊断与治疗提供重要依据。鉴于文章篇幅较长,分为3部分报道。本文为第一部分,主要介绍胰腺炎症相关囊性病变(包括胰腺假性囊肿与胰腺包裹性坏死)与胰腺真性囊肿(包括孤立性胰腺上皮囊肿、von Hippel-Lindau病、多囊肾和囊性纤维化)。     

急性胰腺炎后胰腺假性囊肿的影像表现

由急性胰腺炎引发的胰腺假性囊肿是一种常见的胰腺囊性病变,其特点是临床表现多样、影像表现复杂、并发症多见,相关的影像诊断和鉴别诊断仍然是日常临床工作中的难题之一。主要讨论急性胰腺炎后假性囊肿的各种影像表现和诊断原则,以期为临床诊治胰腺假性囊肿提供有价值的信息。     

胰腺囊性病变的CT诊断

胰腺囊性病变以囊变为特征,是一组不同病理性质和来源的疾病总称.胰腺囊性病变包括:先天性囊肿、假性囊肿、潴留囊肿及囊性肿瘤.随着影像技术的发展,对胰腺囊性病变的诊断水平有了显著的提高~([1]).CT具有优良的空间及密度分辨率,是胰腺病变的首选检查方法.笔者就CT对胰腺囊性病变的诊断作初步探讨.     

胰腺囊腺瘤和囊腺癌螺旋CT表现

目的 探讨胰腺囊腺瘤和囊腺癌螺旋CT表现及特征.方法 回顾分析经病理证实的10例胰腺囊腺瘤和囊腺癌CT影像学特点,10例均行CT平扫及双期增强扫描.结果 CT拟诊胰腺浆液性囊腺瘤2例,黏液性囊腺瘤4例,黏液性囊腺癌2例,胰腺假性囊肿1例,胰腺癌1例,其中CT误诊4例.本组病例提示病灶囊壁厚度,有无壁乳头及钙化的存在等影像学特征,对肿瘤良恶性鉴别诊断有重要意义.结论 通过螺旋CT扫描能够对胰腺浆液性囊腺瘤、黏液性囊腺瘤或囊腺癌作出较为准确的判断.     

von Hippel-Lindau病影像学诊断

目的 探讨von Hippel-Lindau病（VHL病）的影像学特征。资料与方法 回顾性分析7例VHL病影像学表现以及临床、病理资料。结果 7例VHL病影像学表现包括均有1处或1处以上的中枢神经系统血管母细胞瘤,5例有1处或多处包括胰腺多发囊肿、双肾多发肿瘤和囊肿以及阴囊肿瘤在内的内脏病变。结论 VHL病为家族性遗传性多系统肿瘤综合征,熟悉其影像学表现有利于正确诊断。     

胰腺囊性病变的影像学特征分析

胰腺囊性病变是一组以胰腺囊性表现为主的病变,主要包括各种真、假性胰腺囊肿和良恶性胰腺囊性肿瘤。胰腺囊性病变的病因较繁杂,有先天性、炎症性、寄生虫性及肿瘤性等,大部分胰腺囊性病变生长缓慢,多数患者无临床症状,     

腹膜弥漫性病变的18F-FDG PET/CT诊断辨析

腹膜弥漫性病变分为炎性和肿瘤性两类,前者以结核性腹膜炎最为常见,后者以转移瘤最为多见,其次较为多见的是腹膜原发肿瘤,包括腹膜癌、间皮瘤、淋巴瘤等。对腹膜弥漫性病变的鉴别诊断一直是临床工作的难点。由于腹膜弥漫性病变涉及病种多,影像学表现也极为复杂多变,因此笔者选取两例常见类别的腹膜弥漫性病变:腹膜结核和腹膜癌,分别从临床特点及18F-FDG PET/CT影像学特征等方面进行诊断辨析,总结分析诊断思路,为得出准确的临床诊断提供帮助。     

Zystische Tumoren des Pankreas

Cystic lesions of the pancreas encompass a broad spectrum of benign, premalignant, and malignant tumors which are primarily cystic or result from cystic necroses of solid neoplasms. Because of the wide use of cross-sectional imaging techniques they are increasingly being identified in asymptomatic patients as well as in patients presenting with abdominal pain, jaundice or pancreatitis. Among these lesions, intraductal papillary mucinous neoplasms, serous cystic neoplasms and mucinous cystic neoplasms represent the majority of cases. With increasing experience with these tumors, a refinement of our understanding of their morphology and of their natural course has emerged. It is important to be familiar with the CT and MR imaging features of these lesions to differentiate these tumors and to orient the diagnosis towards benign or malignant forms. Because characterization of cystic tumors of the pancreas can sometimes be difficult due to overlapping imaging features, additional criteria such as clinical symptoms, localization, age and gender have to be taken into account. If appropriately treated, these tumors can usually be cured by resection and the decreasing risk of pancreatic surgery has led to an increasing number of resections of pancreatic tumors. The management of cystic tumors of the pancreas has not yet been standardized and the correct evaluation and subsequent management of the disease in asymptomatic patients have not been fully defined.     

胰腺疾病中胰管异常表现及其影像学诊断进展

胰管异常是胰胆管疾病的重要征象,可见于胰腺各种病变;目前胰管异常影像学检查有ERCP、MRCP、MSCT（MDCT）及EUS等均能较好显示胰管形态特征及病变。本文对正常胰管及各种胰腺疾病中胰管异常的影像学表现加以总结。以增进对胰腺疾病的了解。     

Uncommon tumors and pseudotumoral lesions of the pancreas

Ductal adenocarcinoma is the most common tumor of the pancreas, accounting for about 80% of all pancreatic tumors. The other 20% of pancreatic tumors is represented by a heterogeneous group of pancreatic neoplasms that includes cystic pancreatic neoplasms, islet cell tumors, and the so-called rare pancreatic tumors. In addition, the pancreatic gland may present a variety of inflammatory and pseudotumoral lesions that may mimic a primary pancreatic neoplasm. These uncommon tumors and pseudotumoral lesions present a wide spectrum of imaging findings and they are often poorly understood by the radiologist, becoming a diagnostic challenge. Some of these lesions may show an appearance similar to ductal adenocarcinoma being radiologically indistinguishable. However, some of these lesions sometimes may present specific features on imaging studies that may help to characterize the mass and to suggest a correct diagnosis. Many of these uncommon tumors and pseudotumoral lesions have a different approach, therapy, and prognosis than ductal adenocarcinoma. Therefore, it is important for the radiologist to be familiar with these entities to include them in the differential diagnosis to initiate an appropriate lesion-specific workup and treatment. In the present article, we review the radiological features of uncommon pancreatic tumors, atypical manifestations of ductal adenocarcinoma, and pseudotumoral masses, focusing on those features that can be helpful for the differential diagnosis.     

Role of magnetic resonance imaging in the detection and characterization of solid pancreatic nodules: An update

Pancreatic ductal adenocarcinoma is the most common malignant tumor of the pancreas. The remaining pancreatic tumors are a diverse group of pancreatic neoplasms that comprises cystic pancreatic neoplasms, endocrine tumors and other uncommon pancreatic tumors. Due to the excellent soft tissue contrast resolution, magnetic resonance imaging (MRI) is frequently able to readily separate cystic from noncystic tumors. Cystic tumors are often easy to diagnose with MRI; however, noncystic non-adenocarcinoma tumors may show a wide spectrum of imaging features, which can potentially mimic ductal adenocarcinoma. MRI is a reliable technique for the characterization of pancreatic lesions. The implementation of novel motion-resistant pulse sequences and respiratory gating techniques, as well as the recognized benefits of MR cholangiopancreatography, make MRI a very accurate examination for the evaluation of pancreatic masses. MRI has the distinctive ability of non-invasive assessment of the pancreatic ducts, pancreatic parenchyma, neighbouring soft tissues, and vascular network in one examination. MRI can identify different characteristics of various solid pancreatic lesions, potentially allowing the differentiation of adenocarcinoma from other benign and malignant entities. In this review we describe the MRI protocols and MRI characteristics of various solid pancreatic lesions. Recognition of these characteristics may establish the right diagnosis or at least narrow the differential diagnosis, thus avoiding unnecessary tests or procedures and permitting better management.     

Imaging features of benign mass lesions in the nasal cavity and paranasal sinuses according to the 2017 WHO classification

The World Health Organization (WHO) 2017 classification of head and neck tumors has been just published and has reorganized tumors of the nasal cavity and paranasal sinuses. In this classification, three new entities (seromucinous hamartoma, NUT carcinoma, and biphenotypic sinonasal sarcoma) were included, while the total number of tumors has been reduced by excluding tumors if they did not occur exclusively or predominantly in this region. Among these entities, benign tumors were classified as sinonasal papillomas, respiratory epithelial lesions, salivary gland tumors, benign soft tissue tumors, or other tumors. In contrast, inflammatory diseases often show tumor-like appearances. The imaging features of these benign tumors and tumor-like inflammatory diseases often resemble malignant tumors, and some benign lesions should be given attention in the follow-up period and before surgery to avoid recurrence, malignant transformation, or massive bleeding. Understanding the CT and MR imaging features of various benign mass lesions is clinically important for appropriate therapy. The purpose of this article is to describe the clinical characteristics and imaging features of each of clinically important nasal and paranasal benign mass lesions, as classified according to the WHO 2017 classification of head and neck tumors, along with some inflammatory diseases.     

MRI of islet cell tumors of the pancreas

OBJECTIVE: CT is the most widely used imaging technique for the diagnosis of islet cell tumors, but MRI may be better for detecting small lesions and metastases because of its optimal contrast resolution and ability to easily perform dynamic imaging. The purpose of this pictorial essay is to highlight the MRI features of these tumors and underscore potential pitfalls. CONCLUSION: Although classically considered well-defined, arterially enhancing lesions that are bright on T2-weighted sequences, pancreatic islet cell tumors have quite a broad spectrum of appearances. MRI is well suited for detecting and characterizing pancreatic islet cell tumors as well as their local effects and metastases.     

Cystic tumors of the pancreas: imaging and management

Cystic tumors of the pancreas are a subset of rare pancreatic tumors that vary from benign to malignant. Many have specific imaging findings that allow them to be differentiated from each other. This article (1) reviews the imaging features of the common cystic pancreatic lesions, including serous microcystic adenoma, mucinous cystic tumor, intraductal papillary mucinous tumor, and solid pseudopapillary tumor, and including the less common lesions such as cystic endocrine tumors, cystic metastases, cystic teratomas, and lymphangiomas; and (2) provides comprehensive algorithms on how to manage the individual lesions, with recommendations on when to reimage patients.