胰腺导管内乳头状黏液肿瘤的CT诊断

目的 探讨胰腺导管内乳头状黏液肿瘤的CT和MRI表现,分析其诊断要点。方法 回顾性分析12例经手术切除和病理学证实的胰腺导管内乳头状黏液肿瘤的临床、CT和MRI资料。结果 （1）分支胰管型7例,均位于胰头和钩突,CT和MRI主要表现为分叶状或葡萄串样囊性病变,其间可见分隔,增强后囊性区域无强化,囊壁和分隔可强化。（2）混合型5例,4例为胰头或钩突分支胰管扩张合并主胰管扩张;1例同时伴有胰体分支胰管扩张,扩张的主胰管直径为4～7mm。（3）该病多发于老年人,临床主要表现为腹痛和胰腺炎。结论 胰腺导管内乳头状黏液肿瘤有相对特征性的影像学表现,CT和MRI对其诊断有重要价值。

CT diagnosis of intraductal papillary mucinous tumor of the pancreas

Objective To investigate the CT and MRI manifestations of intraductal papillary mucinous neoplasm (IPMN)of the pancreas. Methods Both clinical and imaging data of 12 pathologically confirmed intraductal papillary mucinous neoplasm of the pancreas were retrospectively analyzed. Results The pancreatic IPMN can be classified into two types based on CT image: the branch duct IPMN (n = 7) originated from the head and uncinate process of the pancreas. The tumor consisted of lobulated or clustered small cyst lesions with septa among them, the wall and septa can be enhanced; the combined IPMN(n =5) involved branch ducts of the uncinate process as well as the main pancreatic ducts with dilatation (diameter: 4-7 mm) , one of these involved the branch ducts along the pancreatic body. The pancreatic IPMN was mainly found in elderly patient with a chief clinical symptoms of abdominal pain and/ or pancreatitis. Conclusion The intraductal papillary mucinous neoplasm of the pancreas enjoys specific features in CT and MRI image, which are helpful to the diagnosis.