【2017年整理】胰腺囊性肿瘤鉴别诊断韩宗文.ppt

胰腺囊性病变Pancreas - Cystic Lesions (PCLs);分类;概述;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;诊断思路之路线图;诊断思路;左（假性囊肿）：有胰腺炎病史。有两个单房囊肿，还可见被挤压的腹膜后脂肪组织。 右（囊性肿瘤）：36岁，女性，胰腺尾部囊肿为B超偶然发现。囊肿壁厚而不规则，边缘可见软组织密度结节影。 ? ? ; CT可显示大多数胰腺病变，但有时无法分析其囊内成分。CT能更好地显示在SCN的中央钙化和粘液性囊性肿瘤（MCN）的外周钙化?。 MRI一般优于CT。MR重T2WI、MRCP能更好地显示囊肿性质和内部结构，如在IPMN中还可以显示囊肿与胰管关系。 MRI能更好地显示SCN的中央瘢痕。; ;MR显示SCN中央瘢痕;PCNs;SCN -浆液性囊腺瘤 ;病理;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Serous cystadenoma: Axial oral-contrast-only CT shows a large multicystic pancreatic mass containing central stellate calcification (arrows).;51岁，女，因胆结石、腹痛就诊。 CT示胰头低密度分叶状肿物，中心钙化。 MRI T2示多囊高信号肿物，中心瘢痕伴钙化呈低信号;+C;MCN –粘液性囊性肿瘤 ;病理;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Mucinous cystic neoplasm: Axial noncontrast CT shows a cystic, peripherally calcified mass in the tail of the pancreas (arrow). Pathology at resection showed borderline malignancy.;32岁，女性，左上腹疼痛放射至背部，胰尾部大囊伴边缘钙化，左图可见分隔和厚壁;SCN -浆液性囊腺瘤 ;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;混合型IPMN，胆总管梗阻以致肝内胆管扩张（蓝箭所示），主胰管明显扩张（红箭所示）;Normal T2WI and heavily T2WI with fatsat of a large main duct IPMN with extremely dilated pancreatic duct. ;胰腺炎病人，MRCP示主胰管扩张，分支导管IPMN ;73岁，男性，B超发现胰体部低回声肿物，MRI重T2示其与胰管相通，病理为分支导管IPMN;IPMN 恶变征象;IPMN，蓝箭示扩张的胰管，红箭示胰头部实性结节;SCN -浆液性囊腺瘤 ;26岁，女性，实性假乳头状瘤肝转移;神经内??泌肿瘤囊变;The table shows the American College of Radiology flowchart for imaging of incidentally discovered pancreatic cysts inasymptomatic?patients ;SCN -浆液性囊腺瘤 ;SCN -浆液性囊腺瘤 ;