胰腺囊性病变的MRI诊断

目的　探讨MRI对胰腺囊性病变的诊断价值。方法　回顾性分析 19例经手术病理证实的胰腺囊性病变的MRI表现 ,并与手术病理对照 ,所有病例均行MRI平扫及增强扫描。结果　本组 19例胰腺囊性病变中先天性囊肿 2例 ,MRI表现为典型的长T1长T2 信号 ,囊壁薄而光整 ,囊内无分隔及实性组织成分。潴留性囊肿 3例 ,MRI表现为其与胰管相连 ,囊壁稍厚 ,信号均匀 ,囊肿近端均为胰腺癌。假性囊肿 6例 (急慢性胰腺炎所致 3例、外伤所致 2例、手术所致 1例 ) ,MRI表现为囊壁不规则 ,外伤性假囊肿信号复杂多变 ,胰腺炎性假囊肿MRI表现为长T1长T2 信号。感染性囊肿 3例 (结核 1例、脓肿 2例 ) ,MRI表现无特异性 ,肿瘤性囊肿5例 (浆液性囊腺瘤 2例、粘液性囊腺瘤或囊腺癌 1例、胰腺囊实性肿瘤 1例、胰腺癌囊性变 1例 ) ,肿瘤性囊肿多有软组织成分 ,囊壁多不规则 ,囊内多可见分隔。结论　MRI对胰腺囊性病变的诊断和鉴别诊断具有重要价值。

MRI Diagnosis of Pancreatic Cystic Disease

Objective To investigate the diagnostic value of pancreatic cystic disease by MRI. Methods The MRI features of surgery and pathology proved pancreatic cystic disease in 19 patients were reviewed retrospectively, and were comparatively studied with the results of operation and pathology. All patients received MRI pre- and post-contrast scanning. Results Among the patients 2 cases of congenital cysts, typical long T 1and long T 2 signal intensity were displayed, the walls of the cysts were thin and smooth, and there were no septations and parenchymas in the cysts. 3 cases of retention cysts, the cysts connected to the pancreatic duct, the walls of the cysts were slightly thick, the signal was even, carcinoma of head of pancreas were appeared in all the cases. 6 cases of pancreatic pseudocysts(3 cases were caused by actue/chronic pancreatitis, 2 cases were caused by trauma, 1 case was caused by operation), the walls of the cysts were irregular, the signal of the cysts were various in the cases caused by trauma, long T 1 and long T 2 signal intensity were displayed in the cases caused by pancreatitis. 3 cases of infectious cysts(1 case was caused by tuberculosis, 2 cases were caused by abscessus),There were no specificity on the MRI images.5 cases of neoplastic cysts( 2 cases of serous cystadenomas, 1 case of mucinous cystadenoma or cystadenocarcinoma, 1 case of cystic-soild tumors of pancreas, 1 case of cystic degeneration of pancreatic carcinoma), soft tissue mass always appeared in the cases caused by tumors, the walls of the cysts were irregular, and septations could be seen in the cysts. Conclusion MRI is valuable for the diagnosis and differentiated diagnosis of pancreatic cystic disease.