【作者】 鞠志国；

【导师】 章士正；

【作者基本信息】 浙江大学 ， 临床医学， 2010， 博士

【摘要】 目的：探讨胰腺黏液性囊性肿瘤、浆液性囊腺瘤的多层螺旋CT特征,提高胰腺黏液性囊性肿瘤和浆液性囊腺瘤的多层螺旋CT诊断水平。材料和方法：研究经医院伦理委员会批准,无需签署知情同意书。回顾性分析32例在2003年5月至2009年12月期间我院经手术病理证实的胰腺浆液性囊腺瘤(13例)和黏液性囊性肿瘤患者(19例)的临床资料、多层螺旋CT图像。所有患者均行CT平扫及动态增强扫描。CT图像分析采用单盲法对肿瘤位置、形态、最大囊腔直径、囊壁、分隔、钙化、实性成份、胰腺萎缩、主胰管扩张、边界情况等进行评价。重点比较黏液性囊性肿瘤和浆液性囊腺瘤患者临床特点以及CT征象的差异。分别采用t检验和Fisher精确概率检验法进行统计学分析。结果：19例胰腺黏液性囊性肿瘤中,16例具有临床症状；13例胰腺浆液性囊腺瘤中,8例无明显症状,两者比较差异具有显著性统计学差异(P=0.021<0.05)。最大囊腔直径的分布两者比较差异有统计学意义(t=2.801,P=0.009<0.001),其中囊腔直径大于2cm多见于黏液性囊性肿瘤,与浆液性囊腺瘤之间差异统计学意义(PP=0.01<0.05)。肿瘤实性成分多见于浆液性囊腺瘤,与粘液性囊性肿瘤之间有显著的统计学差异(P=0.029<0.05)结论：胰腺黏液性囊性肿瘤和浆液性囊腺瘤的多层螺旋CT表现形式多样,具有一定特征性。有无临床症状、最大囊腔直径大于2cm及囊腔内实性成份有助于胰腺黏液性囊性肿瘤与胰腺浆液性囊腺瘤的鉴别。更多还原

【Abstract】 OBJECTIVE:The purpose of this study was to determine whether multi-slice helical computed tomography can be used to distinguish mucinous cystic neoplasms from serous cystadenomas of the pancreas.MATERIALS AND METHODS:This study was approved by our hospital institutional review board, but the patient informed consent was waived. Between July 2003 and December 2009, a total of 32 patients with pathologically proven primary cystic pancreatic cystadenomas meeting the including and excluding criteria were retrospectively recruited in this study. Clinical documents and CT images of 32 patients were retrospectively reviewed. Of 32 patients, there were 13 cases of serous cystadenomas and 19 cases of mucinous cystadenomas. CT features such as tumor location, contour, dimension of the largest cyst, cystic wall, septation, presence of calcification, solid component, pancreatic atrophy; main pancreatic duct dilatation and lesion margins were recorded. Statistical analysis was performed to evaluate the efficacy of certain CT findings in the differentiation of serous cystadenomas from mucinous neoplasms.RESULTS:There is statistic difference in presence of clinical symptoms in differentiating mucinous cystic neoplasms (16 out of 19) from serous cystadenomas (8 out of 13) (P=0.021<0.05). The dimension of the largest cyst of the tumor no more than 2cm had a statistically significant association with serous neoplasms (P=0.01<0.05) and the presence of solid component had a statistically significant association with serous cystadenomas (P=0.029<0.05). CONCLUSION:There are some characteristic MSCT features in serous cystadenomas and mucinous cystic neoplasms of the pancreas, allowing MSCT to be a sensitive tool for differentiating serous cystadenoma from mucinous cystic neoplasms.更多还原