超声诊断胰腺囊实性病变

目的评价超声在胰腺囊实性病变鉴别诊断中的价值。 方法回顾58个胰腺囊实性病变的声像图，比较不同疾病超声表现的异同。 结果实性假乳头状瘤（SPT）（14／14个）、无功能胰岛细胞瘤（NFI）（10／11个）和胰腺癌（7／8个）以实性肿物为主。胰腺癌的边缘不光整、实性区域为均匀低回声；SPT和NFI边缘多光整、实性区域回声不一。微囊腺瘤（SCA）主要表现为边缘光整的蜂窝状病变（6／8个）。黏液性囊性肿瘤（MCN）（3／3个）和假性囊肿（8／11个）以囊性为主。 结论超声可准确鉴别胰腺癌囊变和其它疾病；难以区分SPT和NFI；不典型假性囊肿容易误诊为MCN。

Ultrasound Diagnosis of Pancreatic Solid-cystic Diseases

Objective To evaluate the value of ultrasound in the differentiating diagnoses of pancreatic solid-cystic lesions.Methods The ultrasonographic findings and pathologic diagnosis of 58 pancreatic solid-cystic lesions were reviewed and the ultrasonographic characteristics of different diseases were compared.Results All the 14 solid-pseudopapillary tumors(SPT),10 of 11 non-functional islet cell tumors(NFI)and 7 of 8 pancreatic carcinomas appeared as a predominantly solid mass,The pancreatic carcinoma was characterized by homogeneous hypoechoic solid area with irregular margin,whereas most of SPT and NFI had heterogeneous solid areas with regular margins,The honeycomb textures with smooth margin characterized as serous cystadenoma(SCA,n=6/8),All the 3 mucinous cystic neoplasms(MCN)and 8 of 11 pancreatic pseudocysts were shown as predominantly cystic lesions. Conclusions As to US,it is easy to differentiate pancreatic carcinoma with cystic change from other solid-cystic diseases,but,it is difficult to differentiate SPT from NFI and atypical pseudocyst is easy to be misdiagnosed as a mucinous cystic neoplasm(MCN).