Cohen-Scali Frank, Vilgrain Valérie, Brancatelli Giuseppe, Hammel Pascal, Vullierme Marie-Pierre, Sauvanet Alain, Menu Yves
Department of Radiology, Hôpital Beaujon, Clichy, France.
Radiology. 2003 Sep;228(3):727-33. doi: 10.1148/radiol.2283020973.
To compare the computed tomographic (CT) appearance of pancreatic unilocular macrocystic serous cystadenoma, mucinous cystadenoma, and pseudocyst to determine if there are findings that assist in the differential diagnosis.
CT findings in 33 patients (24 women, nine men; age range, 18-84 years; mean age, 41 years) with unilocular pancreatic lesions (macrocystic serous cystadenoma, n = 12; mucinous cystadenoma, n = 11; pseudocyst, n = 10) were retrospectively and jointly reviewed by two blinded observers. Twenty-three patients underwent helical CT, which included pancreatic and portal venous phase imaging with delays of 40 seconds and 65 seconds, respectively, after contrast material injection. Ten patients underwent conventional (nonhelical) CT. The number, size, location, and contour of lesions were reviewed, along with wall thickness and enhancement and other signs of pancreatic and peripancreatic involvement. Diagnosis was based on lesion resection (n = 22) or on a combination of cytologic findings, biochemical markers, and tumor markers (n = 11). The Fisher exact test was used to analyze the results.
Three of four CT findings were independently specific for macrocystic serous cystadenoma: location in the pancreatic head, lobulated contour, and absence of wall enhancement. When two of these four criteria were used in combination, 83% (10 of 12) of patients with unilocular macrocystic serous cystadenoma were identified. When three or four of these criteria were used, a specificity of 100% was achieved. Location in the pancreatic head (P <.05), lobulated contour (P <.005), and lack of wall enhancement (P <.005) were specific for macrocystic serous cystadenoma in comparison with mucinous cystic tumor. Lobulated contours (P <.005) were specific for macrocystic serous cystadenoma in comparison with pseudocyst. Other CT findings were not helpful in distinguishing between the three types of lesions.
A combination of CT findings is helpful in making the diagnosis of pancreatic unilocular macrocystic serous cystadenoma.
比较胰腺单房大囊性腺瘤、黏液性囊腺瘤和假性囊肿的计算机断层扫描（CT）表现，以确定是否存在有助于鉴别诊断的表现。
33例胰腺单房病变患者（24例女性，9例男性；年龄范围18 - 84岁，平均年龄41岁），其中大囊性腺瘤12例、黏液性囊腺瘤11例、假性囊肿10例，由两名不知情的观察者对其CT表现进行回顾性联合分析。23例患者接受螺旋CT检查，包括在注射造影剂后分别延迟40秒和65秒进行胰腺期和门静脉期成像。10例患者接受传统（非螺旋）CT检查。对病变的数量、大小、位置、轮廓进行分析，同时观察壁厚度、强化情况以及胰腺和胰腺周围受累的其他征象。诊断基于病变切除（22例）或细胞学检查结果、生化标志物和肿瘤标志物综合判断（11例）。采用Fisher精确检验分析结果。
四项CT表现中有三项对大囊性腺瘤具有独立特异性：位于胰头、分叶状轮廓和无壁强化。当联合使用这四项标准中的两项时，83%（12例中的10例）单房大囊性腺瘤患者可被识别。当使用三项或四项标准时，特异性达到100%。与黏液性囊性肿瘤相比，位于胰头（P <.05）、分叶状轮廓（P <.0
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