Zhang Jing, Wang Pei-Jun, Yuan Xiao-Dong, Shao Cheng-Wei, Zhao Xiao-Hu, Xu Wei-Guo, Dong Ning-Xin, Wang Guo-Liang, Shao Zhi-Hong, Huang Zong-Liang, Zhang Wei
Department of Radiology, Tongji Hospital of Tongji University, Shanghai 200065, China.
Zhonghua Yi Xue Za Zhi. 2008 Apr 8;88(14):943-7.
To evaluate the diagnostic value of CT in pancreas intraductal papillary mucinous neoplasm (IPMN) by analyzing its CT feature and pathological findings.
The clinical and CT data was analyzed among 39 patients with IPMN whose diagnosis was confirmed by pathology. The CT manifestations were classified into 3 types: simple main pancreatic duct enlargement; main pancreatic duct enlargement combined with pancreatic cystic lesion; and simple pancreatic cystic lesion. The correlation between the CT types and Takada pathological types (main duct type, branch type, and mixed type) was analyzed. All the cases were pathologically classified into benign and malignant/boundary groups. Statistical tests of the difference of CT features (mural nodule, septa, size, caliber of main pancreatic duct and common bile duct) between the 2 groups were performed.
The CT type I matched the main duct type, the CT type II mainly matched the branch type and mixed type, and the CT type III matched the branch type (P < 0.001). The probability of benign lesion was 92% with no mural nodule in the lesion, while the probability of benign lesion was only 42% with mural nodule presented (P = 0.003). In terms of the septa, there was no significant difference between benign and malignant lesions (P = 0.793). The size of malignant/boundary lesions exceeded that of benign lesions (P = 0.016). There were no significant difference in calibers of main pancreatic duct and common bile duct between the benign and malignant/ boundary groups. Without considering pathological grouping the caliber of main pancreatic duct exceeded that of the common bile duct in all the cases (P = 0.02).
CT typing of IPMN well matches the pathological typing which benefits the CT diagnosis of IPMN. The caliber of main pancreatic duct usually exceeds that of common bile duct in IPMN. This feature contributes to its diagnosis.
通过分析胰腺导管内乳头状黏液性肿瘤（IPMN）的CT特征及病理表现，评估CT对其的诊断价值。
分析39例经病理确诊的IPMN患者的临床及CT资料。CT表现分为3型：单纯主胰管扩张；主胰管扩张合并胰腺囊性病变；单纯胰腺囊性病变。分析CT分型与高田病理分型（主胰管型、分支型和混合型）之间的相关性。所有病例病理分为良性和恶性/交界性组。对两组间CT特征（壁结节、分隔、大小、主胰管和胆总管管径）的差异进行统计学检验。
CT I型与主胰管型相符，CT II型主要与分支型和混合型相符，CT III型与分支型相符（P < 0.001）。病变内无壁结节时良性病变概率为92%，而出现壁结节时良性病变概率仅为42%（P = 0.003）。在分隔方面，良性和恶性病变之间无显著差异（P = 0.793）。恶性/交界性病变的大小超过良性病变（P = 0.016）。良性组与恶性/交界性组主胰管和胆总管管径无显著差异。不考虑病理分组时，所有病例主胰管管径均超过胆总管管径（P = 0.02）。
IPMN的CT分型与病理分型良好匹配，有利于IPMN的CT诊断。IPMN中主胰管管径通常超过胆总管管径。这一特征有助于其诊断。
