分支胰管型胰腺导管内乳头状黏液性肿瘤影像学诊断  

Imaging diagnosis of branch duct intraductal papillary mucinous tumors

作　　者：边云[1,2] 高振坡 王莉[1] 陆建平[1] 

机构地区：[1]第二军医大学长海医院影像科,上海200434 [2]解放军411医院

出　　处：《实用放射学杂志》2015年第5期764-767,771,共5页Journal of Practical Radiology

摘　　要：目的：探讨影像学方法对分支胰管型胰腺导管内乳头状黏液瘤（BD-IPMNs）良恶性的诊断价值。方法回顾性分析经手术病理证实的45例 BD-IPMNs 患者的影像学资料。患者术前均行 CT、MRCP、MR 三者中的1种或2种以上检查。分析病变的各种影像学特征,对病变的良恶性进行影像学评分,并与病理分级进行对照。绘制 ROC 曲线来评价影像学方法对 BD-IPMNs 良恶性鉴别的诊断能力。结果主胰管的直径、囊肿直径、厚囊壁、壁结节、胰腺实质的萎缩对鉴别病变的良恶性有统计学意义。影像学诊断 BD-IPMNs 的敏感性94.3%,特异性90%,曲线下面积92.1%,Kappa 值为0.81,P 值为0.0001。结论影像学对于 BD-IPMNs 的诊断以及良恶性的鉴别都具有高度的敏感性,对术前诊断和随访具有一定的价值。Objective To explore the imaging findings of branch duct intraductal papillary mucinous neoplasms （BD-IPMNs）. Methods A total of 45 BD-IPMNs were confirmed by pathology after surgery.The clinical data and imaging findings were retrospec-tively reviewed.Image analysis included characteristics and the nature of the lesions.Finally,an ROC curve was performed to evaluate the differential diagnostic efficacy between benign and malignant lesions using the imaging findings.Results There were statistically significant differences for differential diagnosis of malignant and benign BD-IPMNs in the maximum diameter of the lesions and the MPD,walls,wall nodules,shape,and the atrophy of pancreatic parenchyma （P〈0.05 ）.The diagnostic sensitivity,specificity, AUC and Kappa value of benign and malignant BD-IPMNs were 94.3%,90%,92.1% and 0.81 （P =0.000 1）respectively.Conclu-sion The imaging technology is valuable in diagnosing and differentiating malignant from benign BD-IPMNs.

关 键 词：胰腺肿瘤 导管内乳头状黏液性肿瘤 磁共振成像 计算机体层成像 

分 类 号：R735.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]