Gazelle G S, Mueller P R, Raafat N, Halpern E F, Cardenosa G, Warshaw A L
Department of Radiology, Massachusetts General Hospital, Boston 02114.
Radiology. 1993 Sep;188(3):633-6. doi: 10.1148/radiology.188.3.8394590.
Images from endoscopic retrograde pancreatography performed in 38 patients with cystic pancreatic neoplasms were reviewed to determine whether they might allow differentiation of malignant from benign lesions. Twenty-three patients had histologically proved benign lesions; 15 had frankly malignant lesions. Images were classified into four groups on the basis of the appearance of the pancreatic duct: (a) normal, (b) showing narrowing or draping; (c) showing communication with a cystic space, and (d) showing obstruction. Of the 23 patients with benign lesions, eight had normal studies, 11 had studies showing narrowing or draping, three had studies showing communication, and one had a study showing obstruction. Of the 15 patients with malignant lesions, one had a normal study, three had studies showing narrowing or draping, two had studies showing communication, and nine had studies showing obstruction. Overall, there was a significant difference in the rates of pancreatographic findings for benign and malignant tumors (P = .001). Although no finding proved to be an absolute indicator of benign or malignant disease, obstruction occurred with 60% of malignant tumors and was seen with only one benign lesion (4%).
回顾了38例胰腺囊性肿瘤患者的内镜逆行胰胆管造影图像，以确定这些图像是否有助于鉴别恶性病变和良性病变。23例患者经组织学证实为良性病变；15例为明确的恶性病变。根据胰管表现，图像分为四组：(a)正常；(b)显示狭窄或受压；(c)显示与囊性腔隙相通；(d)显示梗阻。在23例良性病变患者中，8例检查结果正常，11例显示狭窄或受压，3例显示相通，1例显示梗阻。在15例恶性病变患者中，1例检查结果正常，3例显示狭窄或受压，2例显示相通，9例显示梗阻。总体而言，良性和恶性肿瘤的胰胆管造影结果发生率有显著差异(P = .001)。虽然没有任何一项发现被证明是良性或恶性疾病的绝对指标，但60%的恶性肿瘤出现梗阻，而只有1例良性病变出现梗阻(4%)。
