胰腺漿液性囊腺瘤CT表現(xiàn)課件

胰腺漿液性囊性腫瘤CT表現(xiàn)2011-9胰腺漿液性囊腺瘤CT表現(xiàn)背景胰腺漿液性囊性腫瘤（Serouscysticneoplasms,SCNs）大約占所有胰腺囊性腫瘤的20%。鏡下——囊樣結(jié)構(gòu)，周圍包繞富含糖原的立方形細(xì)胞，細(xì)胞內(nèi)含透明稀薄的漿液，同時(shí)可見血管豐富的膠原或透明樣變的基質(zhì)。傳統(tǒng)的觀念認(rèn)為SCN是多個(gè)微囊構(gòu)成的腺瘤，影像上典型表現(xiàn)——蜂窩樣結(jié)構(gòu)，伴中心瘢痕或鈣化。胰腺漿液性囊腺瘤CT表現(xiàn)背景SCN根據(jù)肉眼所見分為5種亞型：漿液性微囊腺瘤——傳統(tǒng)意義上的SCN；漿液性寡囊腺瘤VHL相關(guān)囊性腫瘤實(shí)性漿液性腺瘤漿液性囊腺癌胰腺漿液性囊腺瘤CT表現(xiàn)Typicalhoneycombpatternofserousmicrocysticadenoma胰腺漿液性囊腺瘤CT表現(xiàn)Serousmicrocysticadenomaofthepancreasshowingtypicalimagingfeatures.胰腺漿液性囊腺瘤CT表現(xiàn)Typicalhoneycombpatternwithperipheraloligocysticportion胰腺漿液性囊腺瘤CT表現(xiàn)Atypicaloligocysticpatternofserousoligocysticadenoma胰腺漿液性囊腺瘤CT表現(xiàn)Serousoligocysticadenomaofthepancreasshowingatypicalimagingfeatures.胰腺漿液性囊腺瘤CT表現(xiàn)Atypicalpleomorphicpatternofserousoligocysticadenoma胰腺漿液性囊腺瘤CT表現(xiàn)Serousoligocysticadenomaofthepancreasshowingatypicalimagingfeatures胰腺漿液性囊腺瘤CT表現(xiàn)Atypicalunilocularpatternofserousoligocysticadenoma胰腺漿液性囊腺瘤CT表現(xiàn)Serousmicrocysticadenomaofthepancreasshowingatypicalimagingfeaturesofsolidhypervascularpatternwitholigocysticportion.胰腺漿液性囊腺瘤CT表現(xiàn)Atypicalsolidpatternofsolidserousadenoma胰腺漿液性囊腺瘤CT表現(xiàn)Serousmicrocysticadenomaofthepancreasshowingatypicalimagingfeatures.Awell-demarcatedhypervascularmass(arrows)withlobulatedoutermarginisseeninthetailofthepancreas.Notethedilatationofupstreampancreaticduct(arrowhead)andatrophyofpancreaticparenchyma.Tworadiologistsconfusedthislesionwithaneuroendocrinetumor.胰腺漿液性囊腺瘤CT表現(xiàn)胰腺漿液性囊腺瘤CT表現(xiàn)胰腺漿液性囊腺瘤CT表現(xiàn)胰腺漿液性囊腺瘤CT表現(xiàn)鑒別診斷粘液性囊腺瘤幾乎均發(fā)生于女性約95%位于胰體尾部典型表現(xiàn)——大囊（平均8-10cm）、厚壁、壁結(jié)節(jié)，少數(shù)伴鈣化如病變位于胰頭、呈分葉狀寡囊結(jié)構(gòu)，囊壁無(wú)強(qiáng)化，提示SCN。胰腺漿液性囊腺瘤CT表現(xiàn)胰腺漿液性囊腺瘤CT表現(xiàn)胰腺漿液性囊腺瘤CT表現(xiàn)胰腺漿液性囊腺瘤CT表現(xiàn)胰腺漿液性囊腺瘤CT表現(xiàn)鑒別診斷導(dǎo)管內(nèi)乳頭狀粘液腺瘤好發(fā)于老年男性，平均年齡>60歲，多位于胰頭單房或多房性腫瘤，常伴分隔及壁結(jié)節(jié)；增強(qiáng)掃描，分隔及壁結(jié)節(jié)輕中度強(qiáng)化；主胰管及分支胰管不同程度擴(kuò)張常伴有胰腺的萎縮胰腺漿液性囊腺瘤CT表現(xiàn)胰腺漿液性囊腺瘤CT表現(xiàn)鑒別診斷實(shí)性假乳頭狀瘤男:女20:1發(fā)病年齡，90%<35歲，約6%>50歲通常是單發(fā)、邊界清晰、囊實(shí)性病變，2.5~30cm，可發(fā)生于胰腺的任何部位，約30%伴鈣化可侵犯周圍器官如胃、十二指腸、門脈、脾等，但很少侵犯膽總管胰腺漿液性囊腺瘤CT表現(xiàn)胰腺漿液性囊腺瘤CT