胰腺导管腺癌影像学误诊因素分析

发布时间：2018-05-29 21:37

本文选题：胰腺导管腺癌 + 误诊　；参考：《第二军医大学学报》2015年11期

【摘要】：目的总结胰腺导管腺癌(ductal adenocarcinoma of pancreas,DACP)影像学误诊经验,探讨误诊原因,提高其影像学诊断水平。方法 51例误诊患者中男13例,女38例,年龄37~79岁,中位年龄54岁;所有患者均接受CT和MRI平扫加增强检查,并经术后病理确诊为DACP。回顾对比分析影像学资料与病理结果,总结误诊原因。结果 20例低分化DACP完全无囊性成分,因增强后无明显强化被误诊为"胰腺囊性肿瘤"或"胰腺囊肿";16例DACP伴发假性囊肿因肿瘤被囊肿掩盖而被误诊为"胰腺炎伴假性囊肿";15例DACP伴发阻塞性胰腺炎因肿瘤体积小且被炎症表现掩盖而被误诊为"局灶性胰腺炎"。所有病例(100%)均有边缘不清晰的无强化或轻度强化肿块,43例(84%)出现上游主胰管扩张并至肿瘤处"截断"征象,胆总管扩张至胰腺段"截断"征象在肿瘤位于胰头的病例中占100%。结论熟练掌握胰腺局部解剖及DACP病理组织学特点并了解其常见继发性改变的影像特征有助于避免其影像学误诊。
[Abstract]:Objective to summarize the misdiagnosis experience of ductal adenocarcinoma of pancreatic ductal carcinoma and improve the imaging diagnosis. Methods Fifty-one misdiagnosed patients (male 13, female 38, age 3779 years, median 54 years old) were examined by CT and MRI and confirmed by pathology. The imaging data and pathological results were analyzed retrospectively and the causes of misdiagnosis were summarized. Results there was no cystic component in 20 cases of poorly differentiated DACP. 16 cases of DACP accompanied with pseudocyst were misdiagnosed as "pancreatitis with pseudocyst" because of no obvious enhancement after enhancement: 15 cases of DACP with obstructive pancreatitis The tumor is small and masked by inflammation and misdiagnosed as "focal pancreatitis". In all cases, there were 43 cases with unenhanced or mild enhanced masses with unclear margin) with the upper main pancreatic duct dilated and "truncated" signs to the tumor, and the choledochus dilatation to the pancreatic segment accounted for 100% of the tumors located at the head of the pancreas. Conclusion mastering the regional anatomy of pancreas and the histopathological features of DACP and understanding the imaging features of the common secondary changes are helpful to avoid misdiagnosis.
【作者单位】：宁波市中医院放射科;温州市中心医院放射影像科;第二军医大学长海医院影像医学科;
【基金】：第二军医大学长海医院“1255计划”学科特色提升项目(CH125520804)~~
【分类号】：R735.9;R730.44

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