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目的提高对胰腺导管内乳头状粘液性肿瘤(IPMN)的认识,探讨IPMN在多层螺旋CT(MSCT)上的影像表现。方法回顾15例经内镜逆行胰胆管造影(ERCP)、手术切除病理学证实的胰腺导管内乳头状粘液性肿瘤患者的资料,通过MSCT三期增强扫描、胰腺多平面重组(MPR)、曲面重建(CPR)观察分析其影像特征。结果主胰管型IPMN 4例:表现为胰腺轻度萎缩,主胰管均匀扩张;其中2例诊断为导管内乳头状粘液癌。分支胰管型IPMN 9例:表现单发或多发与胰管相同囊性病变,其中导管内乳头状粘液癌2例,交界性导管内乳头状粘液瘤1例,导管内乳头状粘液瘤6例。混合型IPMN 2例:表现为多囊聚合性病灶,主胰管扩张,其中交界性导管内乳头状粘液癌1例,导管内乳头状粘液瘤1例,2例均可见囊性病变和主胰管相通。结论 IPMN具有特征性影像学表现,MSCT三期扫描,多平面重组、曲面重组建等对病变的诊断、分型,良恶性判定具有重要的临床意义。
Objective To improve the understanding of intraductal papillary mucinous neoplasm (IPMN) in pancreatic duct and investigate the imaging findings of IPMN in multi-slice spiral CT (MSCT). Methods Fifteen patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) underwent surgical resection of pathologically confirmed pancreatic ductal papillary mucinous neoplasms. Three stages of MSCT, MPR and surface reconstruction were performed. (CPR) observation and analysis of its imaging features. Results Four cases of primary pancreatic ductal IPMN showed mild pancreatic atrophy and uniform expansion of the main pancreatic duct. Two of them were diagnosed as ductal papillary mucinous carcinoma. Branch pancreatic IPMN in 9 cases: single or multiple manifestations of cystic lesions with the same pancreatic duct, including ductal papillary mucinous carcinoma in 2 cases, borderline intraductal papillary myxoma in 1 case, ductal papillary myxoma in 6 cases . 2 cases of mixed IPMN: manifested as polycystic polyposis lesions, dilatation of the main pancreatic duct, including borderline ductal papillary mucinous carcinoma in 1 case, ductal papillary myxoma in 1 case, 2 cases were seen cystic lesions and the main pancreatic Tube connected. Conclusions IPMN has characteristic imaging findings. MSCT three-stage scanning, multiplanar reconstruction, surface reconstruction and so on have important clinical significance for the diagnosis, classification, benign and malignant lesions.