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胰腺成像的新见解:从“未探索”到“已探索”。

New insight of pancreatic imaging: from "unexplored" to "explored".

作者信息

Mori Hiromu

机构信息

Department of Radiology, Faculty of Medicine, Oita University, Yufu-City, Oita, Japan.

出版信息

Abdom Imaging. 2010 Apr;35(2):130-3. doi: 10.1007/s00261-008-9471-x. Epub 2008 Nov 6.

Abstract

Pancreatic cancer remains one of the most difficult neoplasms for early diagnosis and treatment. Recent advances of imaging including 3D volume data setting in multidetector-row CT (MDCT) and MRI are urging us to focus on the imaging of normal and pathological conditions of pancreatic parenchyme and peripancreatic structures, which are frequently involved by pancreatic cancers and are affecting the prognosis of patients with pancreatic cancers. In this Feature Section, five main topics of pancreatic imaging are addressed: pancreatic arterial territories, imaging of the intra- and peripancreatic venous anatomy and its clinical significance, imaging of the peripancreatic lymphatic network and its clinical significance for staging of pancreatic cancer, perfusion characteristics of pancreatic cancer to differentiate chronic mass-forming pancreatitis, and development of intraductal papillary mucinus neoplasms of the pancreas (IPMNs) to adenocarcinoma and pancreatic invasion. Recognition and understanding of the imaging anatomy of the pancreas might lead to precise staging of pancreatic cancer and to new approaches of less-invasive treatment. Follow-up of patients with IPMNs of the pancreas on imaging seems, at this time, to be the most valuable strategy in the high-risk group selection.

摘要

胰腺癌仍然是早期诊断和治疗最困难的肿瘤之一。包括多排螺旋CT(MDCT)和MRI中的三维容积数据设置在内的影像学最新进展促使我们关注胰腺实质和胰腺周围结构的正常及病理状况的成像,这些结构常受胰腺癌累及并影响胰腺癌患者的预后。在本专题部分,探讨了胰腺成像的五个主要主题:胰腺动脉区域、胰腺内和胰腺周围静脉解剖结构成像及其临床意义、胰腺周围淋巴网络成像及其对胰腺癌分期的临床意义、胰腺癌的灌注特征以鉴别慢性肿块型胰腺炎,以及胰腺导管内乳头状黏液性肿瘤(IPMNs)向腺癌的发展及胰腺侵犯情况。对胰腺成像解剖结构的认识和理解可能会实现胰腺癌的精确分期,并带来侵入性较小的新治疗方法。目前,对胰腺IPMNs患者进行影像学随访似乎是高危组选择中最有价值的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8089/2852030/3ff4c2dd9cf7/261_2008_9471_Fig1_HTML.jpg

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