胰腺导管内黏蛋白性乳头状瘤CT、MRI诊断及鉴别诊断（附6例报告)

目的:探讨胰腺导管内黏蛋白性乳头状瘤CT、MRI表现特点及诊断价值。方法:6例经手术和病理证实的胰腺导管内黏蛋白性乳头状瘤均行CT平扫及增强检查。4例行MRI检查,其中2例行MRI增强扫描。结合文献，回顾性分析其临床表现及CT、MRI征象表现。结果:本组患者主胰管型5例，混合型1例。CT表现:主要表现为胰腺主胰管或分支胰管不规则扩张，呈分叶状囊性表现，其中4例显示壁结节。增强扫描肿瘤实性部分轻度强化。MRI扫描:胰腺导管不规则扩张,T1WI扩张胰管呈均匀低信号,2例扩张囊壁上见结节样隆起呈等信号。T2WI扩张胰管呈高信号，壁结节显示不清。压脂T1WI扫描肿瘤结节显示清楚。增强扫描肿瘤结节中度强化。结论:CT、MRI对胰腺导管内黏蛋白性乳头状瘤的诊断具有重要价值。

The diagnosis and differential diagnosis of CT and MRI for pancreatic intraductal papillary mucinous tumor(a report of 6 cases)

Objective:To analyze CT and MRI manifestation of intraductal papillary mucinous tumor(IPMT) of the pancreas.Methods:Six cases proved by operation and pathology,plain and enhanced CT was performed in all 6 cases.Of the 6 cases 4 were examined by MRI，and enhanced MRI in 2 cases.Both clinical characteristics and imaging findings of CT and MRI were analyzed retrospectively.Results:Five cases of IPMT showed the main pancreatic duct dilated and 1 case had the main pancreatic duct and its branches dilated.CT manifestations:Mainly for main pancreatic duct or branch of the pancreatic duct was irregularly dilated,lobulated cystic performance,of which 4 cases display wall nodule.Enhancement of the solid part of the tumor showed mild enhancement.MRI scanning:Pancreatic ductal irregular expansion and T1WI dilated pancreatic tube showed homogeneous low signal,2 cases with dilated cystic wall showed nodular uplift and medium signal.T2WI dilatation of pancreatic duct showed high signal,wall nodule showed unclear.Pressure grease T1WI scan tumor nodules show this clearly.Enhancement scan tumor nodules with moderate enhancement.Conclusion:CT and MRI are the most valuable in diagnoses of IPMT.