Choi Byung Se, Kim Tae Kyoung, Kim Ah Young, Kim Kyoung Won, Park Sung Won, Kim Pyo Nyun, Ha Hyun Kwon, Lee Moon-Gyu, Kim Song Cheol
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Radiol. 2003 Jul-Sep;4(3):157-62. doi: 10.3348/kjr.2003.4.3.157.
To compare the usefulness of magnetic resonance cholangiopancreatography (MRCP) and MR angiography (MRA) in differentiating malignant from benign intraductal papillary mucinous tumors of the pancreas (IPMTs), and to determine the findings which suggest malignancy.
During a 6-year period, 46 patients with IPMT underwent MRCP. Morphologically, tumor type was classified as main duct, branch duct, or combined. The diameter of the main pancreatic duct (MPD), the extent of the dilated MPD, and the location and size of the cystic lesion, septum, and communicating channel were assessed. For all types of IPMTs, enhanced mural nodules and portal vein narrowing were evaluated at MRA.
Combined-type IPMTs were more frequently malignant (78%) than benign (42%) (p < 0.05). Compared with benign lesions, malignant lesions were larger, and the caliber of the communicating channel was also larger (p < 0.05). Their dilated MPD was more extensive and of greater diameter (p < 0.05), and the presence of mural nodules was more frequent (p < 0.001).
Combined MRCP and MRA might be useful for the differential diagnosis of malignant and benign IPMTs of the pancreas.
比较磁共振胰胆管造影（MRCP）和磁共振血管造影（MRA）在鉴别胰腺导管内乳头状黏液性肿瘤（IPMT）良恶性方面的作用，并确定提示恶性的表现。
在6年期间，46例IPMT患者接受了MRCP检查。从形态学上，肿瘤类型分为主胰管型、分支胰管型或混合型。评估主胰管（MPD）的直径、MPD扩张的范围以及囊性病变、分隔和连通通道的位置与大小。对于所有类型的IPMT，在MRA上评估强化的壁结节和门静脉狭窄情况。
混合型IPMT的恶性发生率（78%）高于良性发生率（42%）（p<0.05）。与良性病变相比，恶性病变更大，连通通道的管径也更大（p<0.05）。其扩张的MPD范围更广、直径更大（p<0.05），壁结节的出现更频繁（p<0.001）。
联合应用MRCP和MRA可能有助于胰腺IPMT良恶性的鉴别诊断。
