胰腺囊性肿瘤的影像诊断与鉴别诊断

目的 探讨胰腺囊性肿瘤的影像学特征。方法 对19例胰腺囊性肿瘤的B超、CT、钡餐造影检查(GI)和逆行胰胆管造影(ERCP)资料进行回顾性分析。结果 B超：4例囊腺瘤中2例囊性，2例为不均匀的低回声光团。12例囊腺癌均为囊性，部分病例见条索状分隔或乳头状突起。CT：5例囊腺瘤中3例囊性，2例为不均匀低密度肿物；10例囊腺癌皆为囊性，部分病例见囊壁薄厚不均、乳头状突起、囊内分隔及周围浸润征象。GI：胃肠道受压移位。ERCP见胰管受压移位。结论 B超和CT是诊断胰腺囊性肿瘤的有效方法，二者结合使用可提高诊断率。GI和ERCP在鉴别诊断上有一定价值。

Diagnosis and Differential Diagnosis of Imageology of Pancreatic Cystic Tumors

Objective To probe into the image characters of pancreatic cystic tumors. Methods Retrospective analysis were made on the image data of B-ultrasound, CT scan, gastrointestinal barium meal examination (GI) and endoscopic retrograde cholangiopancreatography (ERCP) of 19 patients with cystic tumors of pancreas. Results B-ultrasound: out of 4 cases in cystadenoma, 2 appeared cystic while the other 2 were asymmetric low-echo shadow. All the 12 cystadenocarcinoma cases were cystic. Striate septum or papilla were found in some cases. CT scan: in 5 cystadenoma cases, 3 appeared cystic, 2 were asymmetric low-density mass; all the 10 cystadenocarcinoma cases were cystic. Symptoms as cyst wall of uneven thickness, papilla, separation inside cysts, and infiltration in the surroundings were found in some cases. GI: gastrointestinal tract was displaced by tumor press. ERCP: pancreatic tract was displaced by tumor press. Conclusion B-ultrasound and CT scan are effective in the diagnosis of pancreatic cystic tumors, and a combined use of them can increase the precise rate of diagnosis. GI and ERCP are valuable in the differential diagnosis.