MRI对胰腺囊性肿瘤的诊断价值

目的探讨MRI对胰腺囊性肿瘤的诊断价值。方法回顾分析23例经手术病理证实的胰腺囊性肿瘤资料,总结其影像表现。结果黏液性囊性肿瘤10例,囊性肿块较大,肿块平均直径超过10 cm,由较厚的纤维壁分隔成多房囊肿,外壁光滑,边界清楚。浆液性囊腺瘤6例,病灶较小,囊内有分隔而呈放射状排列,中心瘢痕为其特征性表现。胰腺囊性转移瘤3例,均有肿瘤病史,表现不典型,需结合肿瘤病史定性。胰胚细胞瘤2例,幼儿发病,肿块巨大,肿瘤坏死囊变,形成假-假性囊肿。胰腺乳头状囊实性肿瘤1例,表现为边界清楚的囊实性肿块,囊壁上有壁结节。胰腺毛细血管瘤1例,表现与浆液性囊腺瘤相似,难以术前诊断。结论MRI对胰腺囊性肿瘤具有高度敏感性,不同病变有一定的特征性表现, 对术前定性极有价值。

Diagnostic value of magnetic resonance imaging in pancreatic cystic tumor

Objective To investigate the diagnostic value of MRI in pancreatic cystic tumor. Methods MRI features of pancreatic cystic tumor in 23 patients were reviewed retrospectively, and comparatively studied by taking the results of operation and pathology into account. Results 10 mucinous cystic neoplasms of the pancreas were typically large lesions, with a mean size of 10 cm. These tumors were typically multilocular, with well defined borders, smooth external surfaces, and thick fibrous walls. Unlike mucinous cystic neoplasms of the pancreas, 6 cases of serous cystadenoma were small lesions. The multiple cysts were separated by fibrous septa that radiate from the center. These fibrous bands formed a central stellate scar, which was a characteristic finding. There were three cases of pancreatic cystic metastasis that were difficult to be distinguish from pancreatic cystic tumor without referring to the medical history, for MRI findings were not characteristic. There were two cases of pancreatoblastoma that occurred in female infants, which were characterized by a large heterogeneous multicystic mass. Papillary cystic tumor was well-defined cystic-solid masse with papillary nodes. One case of pancreatic cavernous hemangioma was considered to be serous cystadenoma because their imaging appearances were similar. Conclusions MRI is highly sensitive to pancreatic cystic tumor. Certain characteristic features of different lesions are of great value for preoperative qualitative judgment.