胰腺少见非上皮源性囊性病变的影像表现及文献回顾  

Imaging manifestations and literature review of rare non-epithelial pancreatic cystic lesions

作　　者：陈婧 李红丽 袁媛 CHEN Jing;LI Hongli;YUAN Yuan(Departatent of Radiology,the First College of Clinical Medical Science,China Three Gorges University,Yichang Central People’s Hospital,Yichang,Hubei Province 443000,China;Departatent of Pathology,the First College of Clinical Medical Science,China Three Gorges University,Yichang Central People’s Hospital,Yichang,Hubei Province 443000,China)

机构地区：[1]三峡大学第一临床医学院、宜昌市中心人民医院放射科,湖北宜昌443000 [2]三峡大学第一临床医学院、宜昌市中心人民医院病理科,湖北宜昌443000

出　　处：《实用放射学杂志》2023年第10期1630-1634,共5页Journal of Practical Radiology

摘　　要：目的探讨少见非上皮源性胰腺囊性病变(PCLs)的CT及MRI表现。方法回顾性分析经病理证实的少见胰腺非上皮源性PCLs患者9例的影像资料及相关临床资料,并复习相关文献。结果非上皮源性PCLs共6类:淋巴管瘤2例,血管瘤2例,侵袭性纤维瘤1例,囊性转移瘤1例,炎性肌纤维母细胞瘤2例,自身免疫性胰腺炎的胰内囊性病变1例;影像表现均呈囊实性,边界清楚或不清楚,增强扫描实性部分或分隔影部分无强化,部分渐进性强化,均不伴有上游胰腺实质的萎缩及主胰管扩张。结论胰腺非上皮源性PCLs的影像表现有一定的特征性,淋巴管瘤在CT及MRI上均表现为典型的水样密度及囊性信号,呈“钻缝样”生长方式;血管瘤实性部分强化程度与正常胰腺实质同步;侵袭性纤维瘤呈轻度渐进性强化,侵犯结肠伴少量包裹性积气;转移瘤为多房囊性肿块,影像表现不典型,需要结合肿瘤病史考虑;炎性肌纤维母细胞瘤实性部分呈较明显渐进性强化;自身免疫性胰腺炎的胰内囊性病变见薄壁分隔影,合并胰腺整体形态改变对诊断有帮助。Objective To investigate the CT and MRI manifestations of rare non-epithelial pancreatic cystic lesions(PCLs).Methods Nine patients with rare non-epithelial PCLs confirmed by pathology were collected,and their clinical data and imaging manifestations were analyzed in combination with previous literature reports.Results There were 6 categories of the non-epithelial PCLs:2 cases of cystic lymphangioma,2 cases of hemangioma,1 case of aggressive fibromatosis,1 case of cystic metastasis,2 cases of inflammatory myofibroblastoma,1 case of intra-pancreatic cystic lesions in autoimmune pancreatitis.Among 9 cases of non-epithelial PCLs,all the cases showed solid-cystic lesions,with clear margin or not,the solid components or septa showed no enhancement or progressive enhancement,without pancreatic duct dilatation and upstream atrophy.Conclusion There are some certain characteristics of CT and MRI features of the rare non-epithelial PCLs.On both CT and MRI,the cystic lymphangioma shows typical water-like hypodense and cystic signal,with“drill-like”growth pattern.The solid components of hemangioma present synchronized enhancement with normal pancreatic parenchyma on CT.The aggressive fibromatosis presents with mild progressive enhancement patterns,invading colon with a small amount of enveloping gas.The metastasis is a multilocular cystic mass with atypical imaging manifestation,which should be considered in combination with the tumor history.The solid part of inflammatory myofibroblastoma show obvious progressive enhancement.The intrapancreatic cystic lesions in autoimmune pancreatitis present cystic mass with internal septa,accompanied by the overall morphology change of the pancreas is helpful for diagnosis.

关 键 词：胰腺囊性病变 计算机体层成像 磁共振成像 

分 类 号：R576[医药卫生—消化系统] R814.42[医药卫生—内科学] R445.2[医药卫生—临床医学]