3.0T MRI对胰腺囊性肿瘤的诊断价值

目的：探讨3.0T MRI对胰腺囊性肿瘤的诊断价值。方法：回顾性分析经手术病理证实的30例胰腺囊性肿瘤病例资料,总结其影像表现。结果：①黏液性囊性肿瘤15例,发生于胰腺体、尾部13例,肿瘤较大,平均直径85.0 mm,单囊和多囊各占7例,单囊者壁薄,小于1.5 mm,多囊者囊壁较厚,大于3.0 mm,囊壁持续强化,恶变3例,表现为强化的明显壁结节或不规则明显增厚间隔。②浆液性囊腺瘤9例,发生于胰头7例,平均直径45.0 mm,微囊型5例,3例表现为典型的放射状纤维间隔,大囊型2例,内呈网格状,所有病灶边缘清楚,T2WI均显示低信号间隔,轻度持续强化。③胰腺导管内乳头状瘤3例,均为老年患者,主导管型2例显示为扩张胰管并管内持续强化壁结节,分支型1例,表现为单发与胰管相通囊性灶,无壁结节。④胰腺假性囊实性乳头状瘤2例,均有出血;胰腺癌囊变1例,术前难以诊断。30例胰腺囊性肿瘤病灶均为囊性或囊实性,位于胰头部11例,胰体部9例,胰尾10例。结论：高场强MRI能更好地显示胰腺囊实性肿瘤的囊灶、囊壁、间隔以及实性部分各期的动态变化,结合不同病变的特点和临床,可对术前部分肿瘤定性诊断。

Diagnostic value of 3.0T MR for cystic neoplasms of pancreas

Objective：To investigate the diagnostic value of 3.0T MRI for cystic neoplasms of pancreas.Methods：The data of 30 patients with cystic neoplasms of pancreas were analyzed retrospectively and their imaging features were summarized.Results：①There were 15 cases of mucinous cystadenoma,13 at the body or at the tail of pancreas;they were relatively large,the average diameter was 85.5mm.There were seven cases of monosaccular or multisaccular lesions each.The monosacullar lesion had thin wall with less than 1.5mm,the multisaccular lesion had thick wall with more than 3.0mm.The cystic wall enhanced persistently.There was malignant change in 3 cases,they displayed marked enhancement of mural nodule or irregular thickening of the septa.②There were nine cases of serous cystadenoma,seven in the head of pancreas,the average diameter was 45.0mm;five of them were microsaccular type,3 of the five showed typical radiating fibrous septation;2 of them were macrosaccular type with internal net-like appearance.On T2WI there was hypointense septation,with persistant slight enhancement.③There were three cases of intraductal papilloma,the patients were elderly people.Two of them were main-duct type,showing dilatation of the main duct with persistant enhancement of the mural nodule.One of them was located at side branch of main duct,appeared as a cystic lesion communicating with the duct and without mural nodule.④There were two cases of solid pseudopapillary tumor（PSTP）,bleeding was observed in both cases.There was one case of carcinoma of pancreas with cystic change,which was difficult to diagnose before operation.In total there were 30 cases of cystic tumor of pancreas,they were cystic or cystic-solid.11 case located at the head of pancreas,9 at the body and 10 at the tail of pancreas.Conclusion：3.0T MRI can very well display the cystic component of cystic-solid tumor of pancreas,and display cystic wall,septation and dynamic change of enhancement of the solid part.Integrating these characterictics and clinical manifestation,accurate diagnosis of certain cases of neoplasms can be made.