胰腺浆液性囊腺瘤MSCT表现与病理特征

目的:探讨胰腺浆液性囊腺瘤MSCT表现和病理特征。方法:回顾性分析经手术及病理证实的43例胰腺浆液性囊腺瘤的MSCT表现,观察病灶部位、大小、囊腔类型、中央瘢痕、钙化及强化特点等。结果:43例胰腺浆液性囊腺瘤中,浆液性微囊型囊腺瘤34例,浆液性寡囊型囊腺瘤9例。34例浆液性微囊型囊腺瘤的囊直径平均为(4.2±0.5)cm,其中多囊蜂窝型29例,囊内见多发厚薄不均的蜂窝状分隔,其囊隔厚度为0.03~0.2 cm;多囊海绵型5例,瘤内呈海绵状囊实混杂密度,囊隔显示不清。34例微囊型囊腺瘤内有中央星芒状纤维瘢痕14例,放射状或砂砾状和囊壁上斑点状钙化14例,上游胰管扩张4例。9例浆液性寡囊型囊腺瘤中单囊型4例,呈圆形或卵圆形,囊直径平均为(3.1±3)cm;多囊型5例,边缘呈分叶状,由数个小囊构成,囊壁薄而光滑、均匀,其囊壁厚度<0.1 cm。增强扫描表现:微囊型囊腺瘤中囊内分隔、中央星芒状纤维瘢痕及实性成分多呈轻中度强化,囊内分隔及实性成分越多,强化越明显,中央纤维瘢痕多呈延迟强化;寡囊型囊腺瘤囊内无强化,仅囊壁、囊隔呈轻度强化。结论:胰腺浆液性囊腺瘤CT表现具有一定特征性。微囊型囊腺瘤CT平扫呈蜂窝状或海绵状,瘤中央见星芒状纤维瘢痕及放射状钙化,增强扫描见囊壁、分隔及实性部分呈轻中度或显著强化,中央纤维瘢痕呈延迟强化;寡囊型囊腺瘤由单个或数个大囊组成,无中央纤维瘢痕及钙化,增强扫描见囊壁、囊隔呈轻度强化。

MSCT manifestations and pathological features of serous cystadenoma of pancreas

Objective:To explore the MSCT findings and pathological features of serous cystadenoma of the pancreas(SCP).Methods:The MSCT findings of 43 patients with serous cystadenoma of pancreas confirmed by operation and pathology were analyzed retrospectively.The location,size,cyst type,central scar,calcification and enhancement characteristics of the lesions were observed.Results:In 43 cases of SCP,34 cases were serous microcystic adenomas(SMA),the average diameter of cysts was(4.2±0.5)cm.Among 34 cases of SMA,29 cases of polycystic honeycomb type had multiple thick and thin uneven honeycomb septum with thickness of 0.03~0.2 cm,5 cases of polycystic sponge type had mixed density of cysts and solid,and the cystic septa was unclear.Among 34 cases of SMA,there were 14 cases of central starlike fibrous scars,14 cases of radial or gritty calcification in mass and spotted calcification in cyst wall,and 4 cases of upstream pancreatic duct dilatation.There were 9 cases of serous oligocystic adenoma(SOA),including 4 cases of single cyst type,which were round or oval,with an average diameter of(3.1±3)cm,5 cases of polycystic type,which were lobulated and consisted of several small cysts with thin and smooth cyst wall,with a cyst wall thickness of<0.1 cm.The enhancement showed that the cystic septum,central star-shaped scars and solid components of SMA were mostly mild to moderate enhancement,the more cystic septum and solid components,the more obvious the strengthening,the central fibrous scar was delayed enhancement,no enhancement in the cyst of the SOA,only mild enhancement of the cystic wall and cystic septum.Conclusions:CT findings of SCP have certain characteristics.On plain CT scan,SMA is honeycomb or sponge-like,starlike fibrous scar and radiate calcification are seen in the center of the tumor,and the wall of the cyst,the septum and the solid part are lightly or moderately or significantly enhanced,which is characterized by delayed enhancement of central fibrous scar,SOA consists of single or several large cysts without central fibrous scar and calcification,slight enhancement of cystic wall and cystic septum is characteristic.