Dynamic CT and MR in the diagnosing intraductal papillary mucinous carcinoma of the pancreas and correlation with pathology
CHEN Jian-bo1, ZHOU Jian-jun2, MA Zhou-peng1, ZHANG Shun-zhuang1, MAO Xu-dao1
1. Department of Radiology, Affiliated Cixi Hospital of Wenzhou Medical College, Cixi Zhejiang 315300, China; 2. Department of Radiology, Affiliated Zhongshan Hospital of Fudan University, Shanghai 200032, China
Abstract:Objective: To explore the clinical value of MSCT and MRI findings in the diagnosing intraductal papillary mucinous carcinoma of the pancreas. Materials and Methods: Nine cases of intraductal papillary mucinous carcinoma of the pancreas underwent plain and contrast MSCT and among these 5 cases had plain and contrast MRI scanning. All cases were confirmed by surgical and pathology. The CT and MRI data were reviewed and analysed retrospectively and correlated with surgical and pathologic results. Results: Among the 9 cases, 5 cases were of the main duct type, showed obvious dilation of the main duct of the pancreas, most cases with mural nodules in the duct, which showed high density on CT and inhomogeneous long T1 nad long T2 signal on MRI, the main duct showed long T1 and long T2 signal. Three cases were of the branch-duct type, showed solitary or multiple cystic lesions with septum or nodules within the duct, CT showed high density, MRI showed long T1 long T2 signal. Two cases showed the lesion linked with the main duct. One case belonged to the mixed type showed solitary cystic lesion with nodules in the duct, together with dilation of the main duct, the lesion showed long T1 and long T2 signal. Six cases showed dilation of the main duct(4~45mm). Six cases showed atrophy of the pancreas, 3 cases with dilation of the duodenal papilla, 2 cases with irregular calcifications. After injection of contrast medium the intra-cystic septum was markedly enhanced and the mural nodules within the duct were mildly enhanced. Conclusion: Dynamic thin slice MSCT with MPR, CPR and MRI with MRCP have important value in diagnosing intraductal papillary mucinous carcinoma of the pancreas, small nodules can be showed clearly, and correlated well with pathologic findings. Connected with clinical signs, most cases can be distinguished from benign intraductal papillary mucinous neoplasms of the pancreas.
陈建波;周建军;马周鹏;章顺壮;毛旭道. 胰腺导管内乳头状黏液癌:动态增强CT、MR表现及其病理基础[J]. , 2010, 21(6): 392-395.
CHEN Jian-bo;ZHOU Jian-jun;MA Zhou-peng;ZHANG Shun-zhuang;MAO Xu-dao. Dynamic CT and MR in the diagnosing intraductal papillary mucinous carcinoma of the pancreas and correlation with pathology. , 2010, 21(6): 392-395.