胰腺浆液性囊腺瘤CT表现课件.ppt

胰腺浆液性囊性肿瘤CT表现2011-9胰腺浆液性囊腺瘤CT表现

背景胰腺浆液性囊性肿瘤（Serouscysticneoplasms,SCNs）大约占所有胰腺囊性肿瘤的20%。镜下——囊样结构，周围包绕富含糖原的立方形细胞，细胞内含透明稀薄的浆液，同时可见血管丰富的胶原或透明样变的基质。传统的观念认为SCN是多个微囊构成的腺瘤，影像上典型表现——蜂窝样结构，伴中心瘢痕或钙化。胰腺浆液性囊腺瘤CT表现

背景SCN根据肉眼所见分为5种亚型：浆液性微囊腺瘤——传统意义上的SCN；浆液性寡囊腺瘤VHL相关囊性肿瘤实性浆液性腺瘤浆液性囊腺癌胰腺浆液性囊腺瘤CT表现

Typicalhoneycombpatternofserousmicrocysticadenoma胰腺浆液性囊腺瘤CT表现

Serousmicrocysticadenomaofthepancreasshowingtypicalimagingfeatures.胰腺浆液性囊腺瘤CT表现

Typicalhoneycombpatternwithperipheraloligocysticportion胰腺浆液性囊腺瘤CT表现

Atypicaloligocysticpatternofserousoligocysticadenoma胰腺浆液性囊腺瘤CT表现

Serousoligocysticadenomaofthepancreasshowingatypicalimagingfeatures.胰腺浆液性囊腺瘤CT表现

Atypicalpleomorphicpatternofserousoligocysticadenoma胰腺浆液性囊腺瘤CT表现

Serousoligocysticadenomaofthepancreasshowingatypicalimagingfeatures胰腺浆液性囊腺瘤CT表现

Atypicalunilocularpatternofserousoligocysticadenoma胰腺浆液性囊腺瘤CT表现

Serousmicrocysticadenomaofthepancreasshowingatypicalimagingfeaturesofsolidhypervascularpatternwitholigocysticportion.胰腺浆液性囊腺瘤CT表现

Atypicalsolidpatternofsolidserousadenoma胰腺浆液性囊腺瘤CT表现

Serousmicrocysticadenomaofthepancreasshowingatypicalimagingfeatures.Awell-demarcatedhypervascularmass(arrows)withlobulatedoutermarginisseeninthetailofthepancreas.Notethedilatationofupstreampancreaticduct(arrowhead)andatrophyofpancreaticparenchyma.Tworadiologistsconfusedthislesionwithaneuroendocrinetumor.胰腺浆液性囊腺瘤CT表现

胰腺浆液性囊腺瘤CT表现

胰腺浆液性囊腺瘤CT表现

胰腺浆液性囊腺瘤CT表现

鉴别诊断粘液性囊腺瘤几乎均发生于女性约95%位于胰体尾部典型表现——大囊（平均8-10cm）、厚壁、壁结节，少数伴钙化如病变位于胰头、呈分叶状寡囊结构，囊壁无强化，提示SCN。胰腺浆液性囊腺瘤CT表现

胰腺浆液性囊腺瘤CT表现

胰腺浆液性囊腺瘤CT表现

胰腺浆液性囊腺瘤CT表现

胰腺浆液性囊腺瘤CT表现

鉴别诊断导管内乳头状粘液腺瘤好发于老年男性，平均年龄60岁，多位于胰头单房或多房性肿瘤，常伴分隔及壁结节；增强扫描，分隔及壁结节轻中度强化；主胰管及分支胰管不同程度扩张常伴有胰腺的萎缩胰腺浆液性囊腺瘤CT表现

胰腺浆液性囊腺瘤CT表现

鉴别诊断实性假乳头状瘤男:女20:1发病年龄，90%35岁，约6%50岁通常是单发、边界清晰、囊实性病变，2.5~30cm，可发生于胰腺的任何部位，约30%伴钙化可侵犯周围器官如胃、十二指肠、门脉、脾等，但很少侵犯胆总管胰腺浆液性囊腺瘤CT表现

胰腺浆液性囊腺瘤CT表现

鉴别诊断神经内分泌肿瘤薄层CT可能有助于识别微囊结构MR-T2序列如看到病变呈多个囊状长T2信号及内部低信号分隔有助于诊断胰腺浆液性囊腺瘤C