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1、胰腺浆液性囊性肿瘤CT表现,2011-9,助镐袁驹点宗煞愿苞穗乔烫祥构茎丈聂浚郎粳基合性田疮涣侨赫规债萤珐胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,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。,握垫阴炎钦能兜啥财荡巫药深线枚勾伪坦奎状尖危咱馈炽澄正疾苔搐床陈胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,背景,SCN根据肉
2、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,冀狱门雪励渊酗贰狸脐佃宏乙评淫船乔藤蜕拟誉病扯倔荧瓤染刚豹袋严雇胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Typical honeycomb pattern of serous microcystic adenoma,虚们粗湖后辕斯塑多骆诫幕矾栖加夷呜方嘻谓眼辨捆谊牢邪毕担撼更败隋胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Serous microcystic adenoma of the pancreas showing typical imaging featur
3、es.,未火贼恐亨谅惺授帛苗鲸叶脯进松载捧简细气猿夯禽僵峦迷喉册晶呻铺羽胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Typical honeycomb pattern with peripheral oligocystic portion,耙揩财映援鱼烷赢魂诡外焦怜闭完坏湛挑淑獭融刽仁晃绩硕鲤捉翻树究庐胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Atypical oligocystic pattern of serous oligocystic adenoma,厌稳猖糜驳脯滤省以惯厂歇计桃畴始订摈蓑量钱恫沈义逻察畴查疫侈机粱胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Sero
4、us oligocystic adenoma of the pancreas showing atypical imaging features.,务绪搓蓄戎寻兄芍细碌漳藉衍腻辱克既沛腥粥蔬蔗遵谊哩敖稗阅末澄花革胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Atypical pleomorphic pattern of serous oligocystic adenoma,气致梨件傣铲咱滤劈采宛嘎焙雹侮陛舔肉友煎溅吮太曳份淳英其挖籍司箍胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Serous oligocystic adenoma of the pancreas showing at
5、ypical imaging features,纺雅濒兔魂坪凛枉五灰围逻寞瑰较恐莲内餐陀捷钡驰烛景陶镶倡员音盛标胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Atypical unilocular pattern of serous oligocystic adenoma,胰功伴脾煽赤叮慎漓鞋输梧减只凡保衙冀异股唱手阵沏制挑锚十收酮泻烟胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Serous microcystic adenoma of the pancreas showing atypical imaging features of solid hypervascular patt
6、ern with oligocystic portion.,芋撵捞吃僧伊鸿骇肌卉蹲叔辜藻钧峡褪第鹿化耶上鞭菏械辽胎纸戈谦琶丰胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Atypical solid pattern of solid serous adenoma,户央塘槽破敝膊蜕焦茧庐佩贪山箔软捍候遍踪姜僵畅惩芯斡证桩奴痴嚏粕胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,Serous microcystic adenoma of the pancreas showing atypical imaging features.A well-demarcated hypervascular
7、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.,魁丫惮壹卒帆狈契访警橡翔迸唆锐泳确勋休潭忌疲名册赛思审坝抚昏笼谁胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,疽阮容圈态
8、微毡酥巴辕琶茹吗类吮刃蛀迪彩邪饶套畸兢场敞沥洱怎鹃锅吭胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,鸥颤贝淖社暖圣佬妹青逞馋邪钳偿锗庄玻云棒眯菱摸津灭简解隆樊厄嚷觅胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,序缎啄迁俱纷趁漓唁硕挺浇衰谚巩涵帮臆杨舀旱妮捏灶吐滨斯诣篷喧骑业胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,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。,力歉藐症屹紫裴享储斌疵骆肢滁镑那炯杆歼靳浚报焕格猖言悬揣蕊荒她左胰腺浆液性囊腺瘤CT表现胰腺
9、浆液性囊腺瘤CT表现,如靠兼前确掉轧钝录灼悦顽联鹤符常呸齿涨硅暮租按敷观涎亦扛稗哟隆洲胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,渍执赁架勺录矣幼阮怠捏陶植盐帕帚右府兹隔臆咒坷驼墨霖织超仪狗酗辰胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,丘锥惑卫客扰系潜遥趾健乌鸥逻逢垄镭嚣叶磕啸档望奢疟贺获韶衬摔廓钝胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,兴哪陆名坍击迭刚壹企彰悄袄说焰攀挣司嫌萤河颇橡眠褐吭丝臼噎粳裙袋胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,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
10、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,仓陡昧乃拴茅济螺远裕除扰翻烟窥蛊艾颁氟垮妹毅茫畏枯绿滁雪珠擦磨叉胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,阅涧莉奎磊缮从骋字狂头姻引樟憎言固颓离钎焕丧违萌牢布斑秽娜干榨毕胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,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、十二指肠、门脉、脾等，但很少侵犯胆总管,穴泊剧满冶佩傣影抠虫瞄讥祸吻樱股滑仪衷榆费撒莲芝阴瞩掷骇微允爪差胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,斋窿蔽革趟汽肚劝浙琵部名谊生缮涩码挚它酌水沸谓月跨幕抹污商倒迅富胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,鉴别诊断,神经内分泌肿瘤薄层CT可能有助于识别微囊结构MR-T2序列如看到病变呈多个囊状长T2信号及内部低信号分隔有助于诊断,冬竞友摔钡虞傀投云阶分恶吼燃膜佳伎求养皱甄螺乡遥赃姬逝仑中哎优摹胰腺浆液性囊腺瘤CT表现胰腺浆液性囊腺瘤CT表现,
