胰腺导管内乳头状黏液性肿瘤：薄层螺旋CT表现

Intraductal papillary mucinous tumors of the pancreas: thin-section helical CT findings.

作者信息

Fukukura Y, Fujiyoshi F, Sasaki M, Inoue H, Yonezawa S, Nakajo M

机构信息

Department of Radiology, Faculty of Medicine, Kagoshima University, Kagoshima City, Japan.

出版信息

AJR Am J Roentgenol. 2000 Feb;174(2):441-7. doi: 10.2214/ajr.174.2.1740441.

DOI:10.2214/ajr.174.2.1740441

PMID:10658722

Abstract

OBJECTIVE

The purpose of this study was to evaluate the thin-section helical CT findings of intraductal papillary mucinous tumors and to investigate whether helical CT could distinguish between malignant and benign intraductal papillary mucinous tumors.

MATERIALS AND METHODS

Twenty-seven patients (nine with malignant and 18 with benign intraductal papillary-mucinous tumors) underwent thin-section (3- or 5-mm) helical CT. Two-phase enhanced CT was started 30 and 60-70 sec after injection of contrast material at 3 ml/sec.

RESULTS

In six patients (22.2%), a bulging papilla was depicted on CT. Twenty-five patients (92.6%) had a dilated main pancreatic duct. Cystic lesions were seen in 25 patients (92.6%). Thirteen lesions (48%) were located in the uncinate process, seven (25.9%) were in the head, two (7.4%) were in the body, and three (11%) were in the tail. The cystic lesion was unilocular in five patients (18.5%) and multilocular with a lobulated margin in 20 patients (74%). Communication between the main pancreatic duct and the cystic lesion was depicted in 19 patients (70.4%). The papillary projections corresponding to 3-mm or larger papillary neoplasms were depicted in five patients (18.5%). The bulging papilla was more often observed in malignant than in benign intraductal papillary mucinous tumors (p < 0.05). The caliber of the main pancreatic duct was significantly larger in patients with malignant intraductal papillary mucinous tumors (p > 0.001).

CONCLUSION

The most frequently found feature of intraductal papillary mucinous tumors was a lobulated multilocular cystic lesion located in the uncinate process and in contiguity with the dilated main pancreatic duct. In some patients, a bulging papilla and papillary projections in the ducts, which were specific findings, were visualized on CT. The bulging papilla and the caliber of the main pancreatic duct helped differentiate malignant from benign intraductal papillary mucinous tumors.

摘要

目的

本研究旨在评估导管内乳头状黏液性肿瘤的薄层螺旋CT表现，并探讨螺旋CT能否区分恶性和良性导管内乳头状黏液性肿瘤。

材料与方法

27例患者（9例为恶性导管内乳头状黏液性肿瘤，18例为良性导管内乳头状黏液性肿瘤）接受了薄层（3或5mm）螺旋CT检查。在以3ml/秒的速度注射造影剂后30秒及60 - 70秒开始进行双期增强CT扫描。

结果

6例患者（22.2%）在CT上显示有乳头状隆起。25例患者（92.6%）有主胰管扩张。25例患者（92.6%）可见囊性病变。13个病变（48%）位于钩突，7个（25.9%）位于胰头，2个（7.4%）位于胰体，3个（11%）位于胰尾。5例患者（18.5%）的囊性病变为单房，20例患者（74%）为多房且边缘呈分叶状。19例患者（70.4%）显示主胰管与囊性病变相通。5例患者（18.5%）显示对应于3mm或更大乳头状肿瘤的乳头状突起。恶性导管内乳头状黏液性肿瘤比良性肿瘤更常观察到乳头状隆起（p < 0.05）。恶性导管内乳头状黏液性肿瘤患者的主胰管管径明显更大（p > 0.001）。