胰腺囊性病变的CT诊断价值

目的 探讨CT对胰腺囊性病变的诊断价值。资料与方法 分析54例胰腺囊性病变的CT表现，其中假性囊肿41例，真性囊肿2例，浆液性囊腺瘤3例，黏液性囊腺瘤2例，囊腺癌3例，无功能性胰岛细胞瘤3例。结果 41例假性囊肿CT共检出44个囊性病灶，其中41个病灶为单房囊肿，3个病灶囊内见分隔。40个病灶为低密度，4个病灶为略高密度，增强后均无强化。另见。肾前筋膜增厚(32例)、胰周脂肪层模糊(14例)和胰管扩张(6例)。真性囊肿表现为单发或多发无强化囊性病灶，确诊主要依赖特殊临床资料和组织病理学检查。5例囊腺瘤表现为多房分隔囊性肿块，3例浆液囊腺瘤中2例中央见星芒状钙化，增强后分隔有强化。3例囊腺癌表现为多房分隔囊性病灶，其中2例有肝内多发转移。3例无功能胰岛细胞瘤，2例表现为单房囊性病灶，1例表现为多房分隔及囊内出血。结合病变本身及胰腺和胰周改变(包括肝脏)，CT对假性囊肿诊断的准确性为98．1％，对囊性病变诊断的准确性为90．7％。结论 CT能显示病变本身和胰腺及胰周(包括肝脏)形态学改变，有助于胰腺囊性病变的诊断与鉴别诊断。

Evaluation of CT in the Diagnosis of Cystic Lesions of Pancreas

Objective To evaluate CT scanning in the diagnosis of cystic lesions of the pancreas.Materials and Methods CT manifestations in 54 patients with pancreatic cystic lesions were analyzed. The lesions included pseudocyst (n=41), real cyst (n=2), serous cystadenoma (n=3), mucinous cystadenoma (n=2), cystadenocarcinoma (n=3) and non-functioning islet cell tumor (n=3). Results In 41 patients with pseudocyst, a total of 44 cysts were detected, of which 41 was unilocular and 3 multilocular. Hypoattenuation was seen in 40 lesions and slight hyperattenuation in 4, all cysts showed no enhancement after contrast injection. Other findings included thickened anterior renal fascia (n=32), blurred peripancreatic fat (n=14) and dilated pancreatic duct (n=6). Real cyst appeared as a solitary or multiple non enhanced cystic lesion, and the verification of the diagnosis was based on special clinical data and histopathological exam. Cystadenoma was manifested as multilocular cystic lesion with septa. Of 3 cases with serous cystadenoma, centrally radial calcification was seen in 2. Three cystadenocarcinomas were characterized by multilocular lesions with septa, of which multiple intrahepatic metastases was found in 2. Of three cases with non functioning islet cell tumor, unilocular lesion was seen in two and multilocular lesion in one. The diagnostic accuracy of CT for pseudocystic and cystic lesions of the pancreas was 98.1% and 90.7%, respectively.Conclusion CT scans can well display the pancreatic lesion itself and the peripancreatic and hepatic involvement. CT is very helpful for the diagnosis and differentiation of the cystic lesions of the pancreas.