胰腺少见囊性病变的CT及MRI诊断

目的 探讨胰腺少见囊性肿瘤的影像学特征,提高诊断水平. 方法 回顾分析经手术病理证实的11例少见胰腺囊性肿瘤的临床特征及术前平扫和增强的CT、MRI表现,其中表皮样囊肿4例, 淋巴上皮囊肿4例,淋巴管瘤3例. 结果 (1)表皮样囊肿病变位于胰尾部,囊壁光滑完整,CT平扫囊性病变内的实质成分和脾的密度相同.CT和MRI增强后实质成分表现出和脾完全相同的强化方式.(2)淋巴上皮囊肿老年男性多见,病变呈现多房状境界清楚的肿块.CT平扫呈等密度,MRI T_1WI和T_2WI上混杂的等高信号,增强后囊壁分隔强化.(3)淋巴瘤表现为体尾部的分叶状多囊性病变,CT平扫密度略低于胰腺实质,MRI平扫呈长T_1长T_2信号.增强后分隔和囊壁轻度强化,肿瘤不与胰管交通,胰管轻度受压移位.结论胰腺少见的囊性病变具有一定的特征性的临床和影像学特征.

CT and MRI Diagnosis of Rare Cystic Disease of the Pancreas

Objective To investigate CT and MRI findings of rare cystic disease of the pancreas.Methods Elven cases with rare cystic disease of the pancreas underwent plain and contrast-enhanced CT and MR imaging before operation were reviewed.The clinical presentations and imaging findings were analysed.Among eleven cases,four were epidermoid,four were lymphepithelial cyst and three were lymphangioma.Results (1) Epidermoids located in the tail of the pancreas with smooth wall,the density of parenchyma of the lesons was the same as spleen at CT plain scan.On contrast-enhanced CT and MRI,the parenchyma of the lesions showed the same enhanced pattern with spleen.(2)Lymphepithelial cysts often occurred in olderly men.The lesions appeared as multilocular masses with definite border,isodensity at CT plain scan,and mixed iso-hyperintensity on both T_1WI and T_2WI images.After injection of contrast medium,the wall and septum of the lesions were enhanced.(3)Lymphangiomas were multilocular cystic lesion in the body-tail of the pancreas,hypodense at CT plain scan,and long T_1 and T_2 signal intensity at MRI plain scan.The septum and wall of the lesions were slightly enhanced on contrast-enhanced images.The lesions were not communicated with the pancreatic duct but pancreatic ducts were compressed and slightly shifted.Conclusion CT and MRI findings of rare neoplastic cystic disease of the pancreas are of certain characteristics.