Davenport Matthew S, Caoili Elaine M, Cohan Richard H, Hoff Carrie N, Ellis James H
Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.
J Comput Assist Tomogr. 2010 Jul;34(4):517-22. doi: 10.1097/RCT.0b013e3181d561e4.
To assess the impact of imaging on pancreatic lesion management in von Hippel-Lindau disease (VHL).
We reviewed sequential computed tomography (CT) and magnetic resonance examinations (1997-2008) of 33 patients with VHL who had at least 1 pancreatic lesion.
One hundred sixty-seven imaging studies demonstrated innumerable simple pancreatic cysts and 58 complex pancreatic masses: 24 were complex cystic and 34 were solid (30 small [<or=2 cm] and 4 large [>2 cm]). Aggregate annual growth was significant in complex cystic and solid masses (mean, 0.39 cm/y [P = 0.006] and 0.14 cm/y [P = 0.045]). Solid mass growth differed by size (small: 0.06 cm/y [range, -0.09 to 0.31 cm/y]; large: 1.28 cm/y [range, 0-1.98 cm/y]). Thirteen masses were excised. No patient developed metastases. Arterial-phase CT improved (P = 0.0003) solid mass detection, but 28% of studies still underreported the total number.
Most pancreatic masses in VHL do not require annual surveillance. Arterial-phase CT improves mass detection, but many masses remain prospectively missed.
评估影像学检查对冯·希佩尔-林道病（VHL）胰腺病变管理的影响。
我们回顾了1997年至2008年期间33例患有至少1个胰腺病变的VHL患者的系列计算机断层扫描（CT）和磁共振检查。
167项影像学研究显示有无数个单纯性胰腺囊肿和58个复杂性胰腺肿块：24个为复杂性囊性肿块，34个为实性肿块（30个小肿块[≤2 cm]，4个大肿块[>2 cm]）。复杂性囊性和实性肿块的总体年生长率具有显著性（平均分别为0.39 cm/年[P = 0.006]和0.14 cm/年[P = 0.045]）。实性肿块的生长因大小而异（小肿块：0.06 cm/年[范围，-0.09至0.31 cm/年]；大肿块：1.28 cm/年[范围，0至1.98 cm/年]）。13个肿块被切除。无患者发生转移。动脉期CT改善了（P = 0.0003）实性肿块的检测，但仍有28%的研究前瞻性地漏报了总数。
VHL中的大多数胰腺肿块不需要每年进行监测。动脉期CT改善了肿块的检测，但仍有许多肿块可能被漏诊。
