胰腺囊腺瘤囊性结构及实性成分的CT特点分析  

CT characteristics of pancreatic cystadenoma

作　　者：罗帝林[1] 卢宝兰 肖晓娟[2] 王影[2] 余深平[2] 郑可国[2] 

机构地区：[1]广州医科大学附属深圳沙井医院放射科,广东深圳518104 [2]中山大学附属第一医院放射科,广东广州510080

出　　处：《影像诊断与介入放射学》2015年第3期185-189,共5页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨胰腺浆液性囊腺瘤和胰腺黏液性囊性肿瘤囊性结构及实性成分的CT影像学特点及其诊断价值。方法回顾性分析26例经病理证实为胰腺浆液性囊腺瘤和胰腺黏液性囊性肿瘤瘤患者CT影像资料。结果胰腺浆液性囊腺瘤16例,单囊者7例,多囊且数目小于6个者2例,大于或等于6个者7例;最大囊直径小于2 cm者6例,大于或等于2 cm者10例;囊壁平均厚度1.5 mm（1.0-1.9 mm）;有实性成分者14例,CT增强扫描动脉期轻度强化3例,中度强化7例,明显强化4例,门脉期轻度强化3例,中度强化3例,明显强化8例,动脉期与门脉期强化程度差异有统计学意义（P=0.001）。胰腺黏液性囊性肿瘤10例,单囊者7例,多囊且数目小于6个者2例,超过6个者1例;最大囊直径小于2cm者4例,大于或等于2 cm者6例;囊壁平均厚度2.2 mm（1.1-3.0 mm）;有实性成分者8例,CT增强扫描动脉期轻度强化2例,中度强化5例,明显强化1例,门脉期无强化1例,轻度强化2例,中度强化2例,明显强化3例,动脉期与门脉期强化程度差异有统计学意义（P=0.001）。两组病例囊壁厚度的比较差异具有统计学意义（P=0.031）,3例出现中央瘢痕钙化者均为浆液性囊腺瘤,两组病例实性成分双期增强的比较差异无统计学意义（P动脉期=0.521、P门脉期=0.301）。结论胰腺浆液性囊腺瘤和胰腺黏液性囊性肿瘤囊壁厚度及囊内中央瘢痕钙化对此类疾病的诊断具有重要的临床价值,实性成分在CT双期增强中强化程度的比较无统计学意义。Objective To study the CT appearance of the cystic and solid portions of pancreatic serous cystadenoma（SCA）and mucinous cystadenoma（MCA） for differential diagnosis. Methods CT of 26 patients with pathologically proved SCAs or MCAs was reviewed. T test, Fisher exact, Wilcoxon Signed-Ranks and Mann-Whitney tests were used to compare the CT findings of these two groups. Results The cysts in SCAs were solitary（7 / 16）, 6（2 / 16） or ≥6（7 / 16） measuring ≥2 cm（10 / 16） with median mural thickness of 1.5 mm（range 1.0-1.9 mm）. Solid portions in 14 SCAs showed mild（3）, moderate（7） or marked（4） contrast enhancement in the arterial phase; mild（3）, moderate（3） or marked（8） enhancement in the portal venous phase.The enhancement difference between the two phases was significant（P=0）. The cysts in 10 MCAs were solitary（7）, 6（2） or ≥6（1） measuring ≥2 cm（6 / 10） with median mural thickness of 2.2 mm（range 1.1-3.0 mm）. Solid portions in 8 SCAs showed mild（2）, moderate（5） or marked（1） contrast enhancement in the arterial phase; no（1）, mild（2）, moderate（2） or marked（3） enhancement in the portal venous phase. The enhancement difference between the two phases was also significant（P=0.001） in the MCAs. Difference of thickness of peripheral wall in the two groups was statistically significant（P =0.031）. The presence of central scar and calcification was observed in 3 cases of SCAs and none of the MCAs, which is also helpful for the differential diagnosis between SCAs and MCNs. There were no significant differences of the solid portionenhancement degree in dual-phase enhancement between the two groups（P =0.521 、P =0.301）. Conclusion The thickness of peripheral wall, central scar and calcification showed significant difference between SCAs and MCAs. There were no significant differences of the solid portion enhancement degree in dual-phase enhancement between SCAs and MCAs.

关 键 词：胰腺囊腺瘤 囊性结构 实性成分 双期增强扫描 

分 类 号：R735.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]