胰腺导管内乳头状黏液性肿瘤良恶性的CT鉴别诊断  

Intraductal Papillary Mucinous Neoplasm of the Pancreas：CT Differential Diagnosis of Benign and Malignant Lesions

作　　者：余松涛[1,2] 汪登斌[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,上海200025 [2]蚌埠医学院第一附属医院放射科

出　　处：《实用放射学杂志》2010年第10期1469-1472,共4页Journal of Practical Radiology

摘　　要：目的 探讨CT检查对良、恶性胰腺导管内乳头状黏液性肿瘤（IPMN）的鉴别诊断价值.方法 收集20例经手术病理证实的IPMN患者,其中良性者8例,恶性者12例,恶性中包括胰腺导管内乳头状黏液性交界性肿瘤5例和胰腺导管内乳头状黏液性腺癌（IPMC）7例.回顾性分析其CT表现,分析肿瘤发生部位、肿瘤大小、主胰管宽度、病灶内实性成分及病变内囊的数目等与良恶性的关系.结果 （1）肿瘤发生部位分型与肿瘤性质之间的关系：主胰管型与混合型恶性者有9例,而分支胰管型仅3例为恶性,病变影像表现为主胰管型及混合型者恶性可能性较大（P〈0.05）.（2）病变的大小：恶性组病变最大 直径较良性组大（P〈0.01）,且当病变范围＞30 mm时,恶性可能性较大（P〈0.05）.（3）主胰管（MPD）的宽度：恶性组病变MPD最大宽度明显大于良性组（P〈0.05）,且当MPD宽度＞9 mm时,病变恶性的可能性较大（P〈0.05）.（4）囊内有无合并结节或肿块：恶性组病变合并壁结节或肿块者有8例,良性组病变仅1例见壁结节,两者之间差异显著（P〈0.05）.（5）病变内囊的数目：囊的数目＞3个或者囊内合并不规则隔膜者恶性可能性更大（P〈0.05）.结论 恶性与良性IPMN的CT表现具有差异性,正确的分析能做出鉴别诊断.Objective To explore the value of computed tomography（CT） in differential diagnosis between benign intraductal papillary mutinous neoplasms （IPMNs） of the pancreas and malignant ones. Methods Twenty cases with IPMNs confirmed surgico-- pathologically were recruited in this retrospective study. Of them, 8 eases were benign and 12 were malignant lesions including 5 cases with intraductal papillary mutinous borderline tumor （IPMBT） and 7 with intraductal papillary mutinous carcinoma （IPMC）. The correlation between the CT findings （including duct type, size, diameter of the main pancreatic duct, and solid component and the number of the cyst formations inside the tumor） and the malignancy of IPMNs was retrospectively analyzed. Results （ 1 ）The relationship between the duct type at CT imaging and the pathologic nature of neoplasm ： main pancreatic duct type in 7 and mixed type in 2 cases were malignant, while only 3 eases of branch duct type were malignant. The main pancreatic duct （MPD} type and the mixed type were more likely to be malignant（P〈0.05）. （2）The size of lesions： The maximum diameter of malignant lesions was larger than that of benign lesions（P〈0.01） ,and when the size of the lesion was larger than 30 mm,it was more likely to be malignant（P〈0.05）. （3）The width of MPD： the largest width of MPD in malignant lesions was wider than that in benign lesions（P〈0. 05）, and when the width of MPD was larger than 9mm,it was more likely to be malignant（P〈0.05）. （4）Whether or not with nodule or mass inside： the malignant lesions with nodule or mass were found in 8 cases, and only 1 benign case were found with nodules inside, that was of a significant difference（ P〈0.05 ）. （5 ）The cystic number in lesions： the lesions with more than 3 cysts or combined with irregular septum were more likely to be malignant（P〈0.05）. Conclusion CT findings between malignant and benign IPMNs were different. The analysis of CT characteristics of th

关 键 词：胰腺 导管内乳头状黏液性肿瘤 体层摄影术 X线计算机 

分 类 号：R735.9[医药卫生—肿瘤] R814.42[医药卫生—临床医学]