胰腺浆液性囊腺瘤ct表现

胰腺浆液性囊性肿瘤 CT表现2011-9背景 胰腺浆液性囊性肿瘤（ Serous cystic neoplasms,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。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Typical honeycomb pattern of serous microcystic adenomaSerous microcystic adenoma of the pancreas showing typical imaging features.Typical honeycomb pattern with peripheral oligocystic portionAtypical oligocystic pattern of serous oligocystic adenomaSerous oligocystic adenoma of the pancreas showing atypical imaging features.Atypical pleomorphic pattern of serous oligocystic adenomaSerous oligocystic adenoma of the pancreas showing atypical imaging featuresAtypical unilocular pattern of serous oligocystic adenomaSerous microcystic adenoma of the pancreas showing atypical imaging features of solid hypervascular pattern with oligocystic portion.Atypical solid pattern of solid serous adenomaSerous microcystic adenoma of the pancreas showing atypical imaging features. A well-demarcated hypervascular mass (arrows) with lobulated outer margin is seen in the tail of the pancreas. Note the dilatation of upstream pancreatic duct (arrowhead) and atrophy of pancreatic parenchyma. Two radiologists confused this lesion with a neuroendocrine tumor.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。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 常伴有胰腺的萎缩鉴别诊断实性假乳头状瘤 男 :女 20:1 发病年龄， 90%50岁 通常是单发、边界清晰、囊实性病变，2.530cm，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