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目的:探讨MSCT和MRI对良恶性胰腺导管内乳头状黏液性肿瘤(IPMT)的诊断价值。方法:回顾性分析17例经手术病理证实的IPMT的临床、CT、MRI等影像学资料,其中良性9例、恶性7例,交界性1例。对良性、恶性(包含交界性)IPMT的影像学表现进行分析比较,包括主胰管的扩张程度、胰腺实质囊性病变的直径、有无附壁结节及其直径。结果:IPMT主要表现为胰腺囊性肿块或胰管扩张。9例良性IPMT中主胰管型6例、分支胰管型2例,混合型1例,扩张胰管直径4~7 mm,附壁结节直径2~4 mm;8例恶性IPMT中主胰管型5例,分支胰管型1例,混合型2例,扩张胰管直径10~22 mm,附壁结节直径8~14 mm。结论:良恶性IPMT具有相对特征性的影像学表现,MSCT及MRI对鉴别良恶性IPMT具有一定临床价值。
Objective: To investigate the value of MSCT and MRI in the diagnosis of benign and malignant intraductal papillary mucinous neoplasms (IPMT). Methods: Clinical, CT, MRI and other imaging data of 17 cases of IPMT confirmed by surgery and pathology were retrospectively analyzed. Among them, 9 were benign, 7 were malignant and 1 was borderline. The imaging findings of benign and malignant (including borderline) IPMT were analyzed and compared, including the extent of dilatation of the main pancreatic duct, the diameter of pancreatic parenchymal cystic lesions, the presence or absence of ancillary nodules and their diameters. Results: IPMT mainly manifested as pancreatic cystic mass or pancreatic duct dilatation. In 9 cases of benign IPMT, there were 6 cases of primary pancreatic duct, 2 cases of branch pancreatic duct, 1 case of mixed duct, 4 ~ 7 mm of expanded pancreatic duct and 2 ~ 4 mm of appendix wall. 5 cases of tube type, 1 branch of pancreatic duct type and 2 of mixed type. The diameter of the expanded pancreatic duct was 10-22 mm, and the diameter of the adherent wall was 8-14 mm. Conclusion: The benign and malignant IPMT has relatively characteristic imaging manifestations. MSCT and MRI have certain clinical value in differentiating benign and malignant IPMT.