影像学检查对胰腺良性肿瘤的诊断进展

doi:10.3877/cma.j.issn.1674-0793.2016.01.018

临床上胰腺良性肿瘤发病率较胰腺恶性肿瘤低。但随着检查技术的提高，胰腺良性肿瘤的检出率越来越高。准确的影像学诊断对于鉴别肿瘤的良恶性有着十分重要的作用，对于临床选择合适的治疗方案至关重要。为此，本文就胰腺良性肿瘤的影像表现及诊断研究进展做简要综述。

关键词: 胰腺肿瘤, 超声检查, 磁共振成像

The incidence of pancreatic benign tumors is lower than that of pancreatic malignant tumors in previous clinical record. However, with the wide accessible and application of sophisticated equipments and techniques in recent decades, more pancreatic benign tumors have been detected. Accu-rate imaging diagnosis and differential diagnosis of pancreatic tumors is one of important approaches to differentiate tumor benignancy or malignancy, and it is essential for clinicians to select proper treatment and management. The purpose of this article is to review the current medical imaging diagnosis of the be-nign pancreatic tumors and to highlight progress in this field.

Key words: Pancreatic neoplasms, Ultrasonography, Magnetic resonance imaging

1	周晓军,樊祥山.解读2010年消化系统肿瘤WHO分类Ⅲ[J].临床与实验病理学杂志, 2011, 27(4): 341-346.
2	Mortele KJ. Cystic pancreatic neoplasms: imaging features and management strategy[J]. Semin Roentgenol, 2013, 48(3): 253-263.
3	张晖,王文平,徐智章,等.胰腺浆液性囊腺瘤的超声诊断价值[J].上海医学影像, 2008, 17(4): 283-285.
4	D'Onofrio M,Crosara S,Canestrini S, et al. Virtual analysis of pancreatic cystic lesion fluid content by ultrasound acoustic radi-ation force impulse quantification[J]. J Ultrasound Med, 2013, 32(4): 647-651.
5	林晓珠,陈克敏,吴志远,等. CT能谱成像在鉴别胰腺寡囊型浆液性囊腺瘤与黏液性囊腺瘤中的价值[J].中华放射学杂志, 2011, 45(8): 713-717.
6	Li C,Lin X,Hui C, et al. Computer-aided diagnosis for distin-guishing pancreatic mucinous cystic neoplasms from serous oligo-cystic adenomas in spectral CT images[J]. Technol Cancer Res Treat, 2014. Dec. pit:1533034614563013.
7	徐明,徐作锋,谢晓燕,等.超声造影在胰腺囊实性病变鉴别诊断中的应用价值[J].中华超声影像学杂志, 2014, 23(10): 869-874.
8	Yoon WJ,Brugge WR. Pancreatic cystic neoplasms: diagnosis and management[J]. Gastroenterol Clin North Am, 2012, 41(1): 103-118.
9	Nguyen D,Dawson DW,Hines OJ, et al. Mucinous cystic neo-plasms of the pancreas: are we overestimating malignant poten-tial?[J]. Am Surg, 2014, 80(10): 915-919.
10	Park JW,Jang JY,Kang MJ, et al. Mucinous cystic neoplasm of the pancreas: is surgical resection recommended for all surgical-ly fit patients?[J]. Pancreatology, 2014, 14 (2): 131-136.
11	Manfredi R,Ventriqlia A,Mantovani W, et al. Mucinous cystic neoplasms and serous cystadenomas arising in the body-tail of the pancreas: MR imaging characterization[J]. Eur Radiol, 2015, 25(4): 940-949.
12	Lévy P,Jouannaud V,O'Toole D, et al. Natural history of intra-ductal papillary mucinous tumors of the pancreas: actuarial risk of malignancy[J]. Clin Gastroenterol Hepatol, 2006, 4(4): 460-468.
13	Fritz S,Klauss M,Berqmann F, et al. Pancreatic Main-Duct In-volvement in Branch-Duct IPMNs: an Underestimated Risk[J].Ann Surg, 2014, 260(5): 848-855.
14	Pezzilli R,Serra C,Calculli L, et al. Three-dimensional contrast-enhanced ultrasonography of intraductal papillary mucinous neo-plasms of the pancreas: a comparison with magnetic reso-nance imaging[J]. Pancreas, 2013, 42(7): 1164-1168.
15	殷小平,冯宝,李秋平,等. MSCT及MRI对胰腺导管内乳头状黏液性肿瘤的诊断[J].实用放射学杂志, 2013, 29(12): 2059-2062.
16	Walter TC,Steffen IG,Stelter LH, et al. Implications of imaging criteria for the management and treatment of intraductal papillary mucinous neoplasms-benign versus malignant findings[J]. Eur Ra-diol, 2015, 25(5): 1329-1338.
17	Fatima Z,Ichikawa T,Motosugi U, et al. Magnetic resonance dif-fusion-weighted imaging in the characterization of pancreatic mu-cinous cystic lesions[J]. Clin Radiol, 2011, 66(2): 108-111.
18	Kim SH,Lee JM,Lee ES, et al. Intraductal papillary mucinous neoplasms of the pancreas: evaluation of malignant potential and surgical resectability by using MR imaging with MR cholangiogra-phy[J]. Radiology, 2015, 274(3): 723-733.
19	Jang KM,Kim SH,Min JH, et al. Value of diffusion-weighted MRI for differentiating malignant from benign intraductal papil-lary mucinous neoplasms of the pancreas[J]. AJR, 2014, 203(5): 992-1000.
20	Kang KM,Lee JM,Shin CI, et al. Added value of diffusion-weighted imaging to mr cholangiopancreatography with unen-hanced MR imaging for predicting malignancy or invasiveness of intraductal papillary mucinous neoplasm of the pancreas[J]. J Magn Reson Imaging, 2013, 38(3): 555-563.
21	Kang KM,Lee JM,Yoon JH, et al. Intravoxel incoherent motion diffusion-weighted MR imaging for characterization of focal pan-creatic lesions[J]. Radiology, 2014, 270(2): 444-453.
22	Zhang Y,Frampton AE,Martin JL, et al. ¹⁸F-fluorodeoxyglucose positron emission tomography in management of pancreatic cystic tumors[J]. Nucl Med Biol, 2012, 39(7): 982-985.
23	Tomimaru Y,Takeda Y,Tatsumi M, et al. Utility of 2-¹⁸F-fluoro-2-deoxy-D-glucose positron emission tomography in differential diagnosis of benign and malignant intraductal papillary-muci-nous neoplasm of the pancreas[J]. Oncol Rep, 2010, 24(3): 613-620.
24	Baiocchi GL,Bertaqna F,Gheza F, et al. Searching for indicators of malignancy in pancreatic intraductal papillary mucinous neo-plasms: the value of ¹⁸FDG-PET confirmed[J]. Ann Surg Oncol, 2012, 19(11): 3574-3580.
25	陈志奎,张秀娟,柯丽明,等.胰腺实性假乳头状瘤声像图特征及误诊分析[J].中国超声医学杂志, 2012, 28(8): 745-747.
26	李巧凤,蒋天安,赵齐羽,等.胰腺实性假乳头状瘤的超声造影表现[J].中国超声医学杂志, 2014, 30(6): 538-541.
27	Raman SP,Kawamoto S,Law JK, et al. Institutional experience with solid pseudopapillary neoplasms: focus on computed tomog-raphy, magnetic resonance imaging, conventional ultrasound, en-doscopic ultrasound, and predictors of aggressive histology[J]. J Comput Assist Tomogr, 2013, 37(5): 824-833.
28	司安创,杨晓春,庞红艳.胰腺实性假乳头状瘤的CT表现[J].实用放射学杂志, 2013, 29(2): 228-231.
29	Chae SH,Lee JM,Baek JH, et al. Magnetic resonance imaging spectrum of solid pseudopapillary neoplasm of the pancreas[J]. J Comput Assist Tomogr, 2014, 38(2): 249-257
30	马小龙,蒋慧,汪建华,等.囊型胰腺实性-假乳头状瘤影像特征及与病理对照研究[J].中华放射学杂志, 2012, 46(12): 1143-1145.
31	Yao XZ,Yun H,Zeng MS, et al. Evaluation of ADC measure-ments among solid pancreatic masses by respiratory-triggered dif-fusion-weighted MR imaging with inversion-recovery fat-sup-pression technique at 3.0 T[J]. Magn Reson Imaging, 2013, 31(4): 524-528.
32	魏黎明,鲁海涛,赵俊功.胰腺连续动态增强CT术前诊断胰岛素瘤的价值[J].临床放射学杂志, 2014, 33(5): 717-721.
33	Lin XZ,Wu ZY,Tao R, et al. Dual energy spectral CT imaging of insulinoma-Value in preoperative diagnosis compared with con-ventional multi-detector CT[J]. Eur J Radiol, 2012, 81(10): 2487-2494.
34	张静,林晓珠,陈克敏,等. MRI和能谱CT成像在胰岛素瘤诊断中的初步研究[J].临床放射学杂志, 2014, 33(3): 368-372.
35	Sowa-Staszczak A,Pach D,Mikolajczak R, et al. Glucagon-like peptide-1 receptor imaging with [Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-exendin-4 for the detection of insulinoma[J]. Eur J Nucl Med Mol Imaging, 2013, 40(4): 524-531.
36	Luo Y,Yu M,Pan Q, et al. ⁶⁸Ga-NOTA-exendin-4 PET/CT in detection of occult insulinoma and evaluation of physiological up-take[J]. Eur J Nucl Med Mol Imaging, 2015, 42(3): 531-532.
37	陈穹,郑穗生,王钢,等.胰腺实性假乳头状瘤与无功能神经内分泌肿瘤的MSCT鉴别诊断[J].放射学实践, 2014, 29(7): 818-822.

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Progress in imaging diagnosis of benign pancreatic tumors

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Progress in imaging diagnosis of benign pancreatic tumors