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目的:探讨磁共振成像(MRI)在鉴别良恶性胰腺导管内乳头状黏液性肿瘤中的应用价值。方法:筛选2014年1月至2015年5月梁平县人民医院收治的胰腺导管内乳头状黏液性肿瘤患者78例。所有患者均经病理实验结果证实,其中良性肿瘤患者41例,恶性肿瘤37例,术前行胰腺MRI检查并根据MRI影像结果进行诊断。结果:MRI确诊良性胰腺导管内乳头状黏液性肿瘤38例,与病理结果比较,差异无统计学意义(P>0.05),并且MRI评估良性肿瘤中,主胰管型10例,分支胰管型19例,混合型9例,其中主胰管型患者胰管扩张直径在4~7 mm,分支胰管型患者中9例位于胰头,10例位于钩突部,与术中所见及病理结果比较,差异无统计学意义(P>0.05);MRI确诊恶性胰腺导管内乳头状黏液性肿瘤33例,其中主胰管型19例,分支胰管型8例,混合型6例,主胰管型患者中15例位于胰头,4例位于胰尾,胰管扩张直径为10~22 mm,与术中所见及病理结果比较,差异无统计学意义(P>0.05)。结论:MRI可准确鉴别诊断良恶性胰腺导管内乳头状黏液性肿瘤,并可评估病理分型及病灶形态、累及程度等,在指导临床治疗方案的选择与预后评估中具有重要价值。
Objective: To investigate the value of magnetic resonance imaging (MRI) in differentiating benign and malignant pancreatic ductal papillary mucinous neoplasms. Methods: From January 2014 to May 2015, 78 cases of pancreatic ductal papillary mucinous neoplasms were treated in Liangping People’s Hospital. All patients were confirmed by pathological results, of which 41 cases of benign tumors, 37 cases of malignant tumors, preoperative pancreatic MRI examination and MRI findings based on diagnosis. Results: Thirty-eight cases of papillary mucinous tumors in benign pancreatic duct were diagnosed by MRI. There was no significant difference between the two groups (P> 0.05) 19 cases and mixed type in 9 cases. Among them, the diameter of pancreatic duct dilatation in patients with primary pancreatic duct was 4 ~ 7 mm, 9 cases in branch and pancreatic duct were located in the head of pancreas, and 10 cases were located in the uncinate process. Results There was no significant difference between the two groups (P> 0.05). MRI confirmed 33 cases of malignant pancreatic papillary mucinous neoplasms, of which 19 were major pancreatic duct type, 8 were pancreatic duct type, 6 were mixed type, Fifteen cases were located in the head of the pancreas and four were located at the tail of the pancreas. The diameter of the pancreatic duct was 10-22 mm. There was no significant difference between the two groups (P> 0.05). Conclusion: MRI can accurately differentiate papillary mucinous neoplasms in benign and malignant pancreatic ductal diseases, and can evaluate the pathological type, lesion morphology and degree of invasion, which is of great value in guiding the choice of clinical treatment plan and prognosis evaluation.