本文選題：胰腺導(dǎo)管腺癌 + 誤診　； 參考：《第二軍醫(yī)大學(xué)學(xué)報》2015年11期

【摘要】：目的總結(jié)胰腺導(dǎo)管腺癌(ductal adenocarcinoma of pancreas,DACP)影像學(xué)誤診經(jīng)驗(yàn),探討誤診原因,提高其影像學(xué)診斷水平。方法 51例誤診患者中男13例,女38例,年齡37~79歲,中位年齡54歲;所有患者均接受CT和MRI平掃加增強(qiáng)檢查,并經(jīng)術(shù)后病理確診為DACP。回顧對比分析影像學(xué)資料與病理結(jié)果,總結(jié)誤診原因。結(jié)果 20例低分化DACP完全無囊性成分,因增強(qiáng)后無明顯強(qiáng)化被誤診為"胰腺囊性腫瘤"或"胰腺囊腫";16例DACP伴發(fā)假性囊腫因腫瘤被囊腫掩蓋而被誤診為"胰腺炎伴假性囊腫";15例DACP伴發(fā)阻塞性胰腺炎因腫瘤體積小且被炎癥表現(xiàn)掩蓋而被誤診為"局灶性胰腺炎"。所有病例(100%)均有邊緣不清晰的無強(qiáng)化或輕度強(qiáng)化腫塊,43例(84%)出現(xiàn)上游主胰管擴(kuò)張并至腫瘤處"截斷"征象,膽總管擴(kuò)張至胰腺段"截斷"征象在腫瘤位于胰頭的病例中占100%。結(jié)論熟練掌握胰腺局部解剖及DACP病理組織學(xué)特點(diǎn)并了解其常見繼發(fā)性改變的影像特征有助于避免其影像學(xué)誤診。
[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.
【作者單位】： 寧波市中醫(yī)院放射科;溫州市中心醫(yī)院放射影像科;第二軍醫(yī)大學(xué)長海醫(yī)院影像醫(yī)學(xué)科;
【基金】：第二軍醫(yī)大學(xué)長海醫(yī)院“1255計劃”學(xué)科特色提升項(xiàng)目(CH125520804)~~
【分類號】：R735.9;R730.44

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本文編號：1952478