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胞，細胞內(nèi)含透明稀薄的漿液，同時可見血管豐富的膠原或透明樣變的基質(zhì)。傳統(tǒng)的觀念認為SCN是多個微囊構(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)，囊壁無強化，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)；增強掃描，分隔及壁結(jié)節(jié)輕中度強化；主胰管及分支胰管不同程度擴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