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| The value of magnetic resonance imaging in the differential diagnosis of pancreatic cystic neoplasms |
| Department of MRI, the First Hospital of Qiqihaer City, Qiqihaer Heilongjiang 161005, China |
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Abstract Objective: To analyze the morphological characteristics of pancreatic cystic neoplasms that have been pathologically proved to discuss the value of MRI in the differential diagnosis of pancreatic cystic neoplasms retrospectively. Methods: Totally 38 cases of pancreatic cystic neoplasms were included in the study from 2010 April to 2015 April, including male 25, female 13, age range 32～64 years. All the cases underwent MRI in our hospital and were pathologically proved. Among them serous cystic neoplasm(SCN) 16 cases, mucinous cystic neoplasms(MCN) 12 cases, solid pseudopapillary neoplasm(SPN) 6 cases and intraductal papillary mucinous neoplasm(IPMN) 4 cases. Results: SCN were usually lobular with many small cysts and central scars. The septum enhanced significantly to be high signal intensity after dynamic-contrast enhancement. MCN were usually large volume, mean diameter 76.0 mm. The mural nodule and irregulary thickened septum enhanced obviously. Eight cases of MCN were located in the body and tail of pancreas. Six cases of SPN were all cystic-solid, 4 cases of cystic dominated and 2 cases of solid dominated with intact capsule of ring low signal intensity. The solid portion showed slightly-low T1 and slightly-high T2 signals, while the cystic portion showed low T1 and high T2 signals. After contrast dynamic enhancement, the solid portion enhanced gradually to be high signal intensity comparing with the adjacent pancreatic normal tissues. The cystic portion didn’t enhance to be low signal. Three cases of IPMN were major pancreatic duct with the duct remarkedly dilated, the maximum diameter was 5.0 mm. The papillary with slightly-low T1 and slightly-high T2 signal can be seen in the duct, enhanced gradually. Only 1 case was branch-type located in the tail of pancreas with many cysts of long T1 and long T2 signals, enhanced significantly. In MRCP, 4 cases can be seen to communicate with the pancreatic duct, companying the distal or whole pancreatic duct dilation, while the duct only showed proximal dilation in SCN and MCN. Conclusion: High field magnetic resonance can significantly improve the diagnostic accuracy by showing the different morphological characteristics of cystic center, cystic capsule and septum in the pancreatic cystic neoplasms.
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Received: 24 July 2015
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Corresponding Authors:
PENG Xiao-gang
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