目的探讨胰腺黏液性囊腺肿瘤的CT表现,以提高对该肿瘤的鉴别诊断水平。方法回顾性分析20例经病理证实的胰腺黏液性囊腺肿瘤患者的CT资料,分别由2名医师采用盲法对肿瘤囊的数量、大小、位置、边界、壁厚度、分隔、肿瘤内钙化、壁结节和强化情况进行评价。所有患者均行CT平扫及增强扫描,比较良恶性病变患者上述征象的差异。采用Fisher检验进行统计学分析。结果良性胰腺黏液性囊腺肿瘤(黏液性囊腺瘤)12例,恶性胰腺黏液性囊腺肿瘤8例(其中包括3例交界性黏液性囊腺瘤和5例黏液性囊腺癌)。16例(16/20)病灶位于胰腺体尾部。12例良性黏液性囊腺瘤中出现厚壁4例,肿瘤内钙化和壁结节各2例;而8例恶性胰腺黏液性囊腺肿瘤中出现厚壁7例,肿瘤内钙化和壁结节各5例,厚壁、肿瘤内钙化和壁结节在良恶性肿瘤间差异有统计学意义(P〈0.05)。结论胰腺黏液性囊腺肿瘤的CT表现形式多样,具有一定特征性,其征象有助于胰腺黏液性囊腺肿瘤的良恶性鉴别。
Objective To analyze the CT appearances with pathologic correlation and improve the recognition of pancreatic mucinous cystadenoma/cystadenocarcinoma. Methods CT findings in 20 patients with pathologically proven pancreatic mucinous cystic tumor were retrospectively and jointly reviewed by two observers blinded to the pathological results. All patients underwent precontrast and postcontrast helical CT. The number, size, location, and margins of the lesions were observed, along with wall thickness, septation, calcification within the lesions, and presence of mural nodules and their enhancement. The findings of malignant and benign tumors were compared. Results Twelve cases of mucinous cystadenoma, 3 berderline cystadenomas and 5 cystadenocacinomas were included in this study. Sixteen tumors (16/20) were located at pancreatic body or tail The findings of thick walsl, calcifications and mural nodules appeared in 4, 2 and 2 cases respectively in benign mucinous cystic tumors, while appeared in 7, 5, and 5 cases respectively in malignant mucinous cystic tumors. Presence of thick walls, calcifications and mural nodules in the lesions were significantly associated with malignancy (P 〈 0. 05 ). Conclusion CT manifestations of pancreatic mucinous neoplasm are variable, but has some specific radiographic features. A combination of CT findings is helpful in differentiation of malignant and benign pancreatic mucinous adenomas.