医学影像学胰腺囊性病变的诊断PPT课件
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Intraductal Papillary Mucinous Neoplasm (IPMNs)
Side-branch IPMNs can have two different imaging appearances: a macrocystic pattern, in which there is a unilocular or multilocular cyst with few septa, and a microcystic pattern, in which multiple thin septa separate numerous fluid-filled spaces.
6
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Main-duct IPMN. (1)CT image demonstrates diffuse irregular dilatation of the main pancreatic duct with heterogeneous intraductal densities (arrow). (2) MRCP demonstrates a dilated main pancreatic duct with areas of irregular stenosis (arrows).
8
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Ø At CT, Side-branch IPMNs usually appear as hypoattenuating heterogeneous lesions and are classically located in the uncinate process, but they can be found anywhere in the pancreas. Ø At MR, side-branch IPMNs usually appear as small round or oval lobulated masses. A connection to the pancreatic duct is often demonstrated on cross-sectional images. Approximately 30% of sidebranch IPMNs are multifocal.
5
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Ø At CT, a main-duct IPMN may demonstrate diffuse or segmental dilatation of the main pancreatic duct. Ø At MR, a main-duct IPMN may demonstrate diffuse or segmental ductal dilatation, with hypointense T1 and hyperintense T2 signal. Mural nodules, mucin globules, or a dilatated major or minor papilla bulging into the duodenal lumen may be seen. Parenchymal atrophy may also be present.
2
Introduction
Ø The primary cystic lesions of the pancreas include intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, serous cystadenomas, pseudocysts, and true epithelial cyst. Ø The solid neoplasms undergoing cystic degeneration include neuroendocrine tumors, solid pseudopapillary neoplasms, and, rarely, adenocarcinoma and its variants.
3
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Ø IPMNs originate from the mucinous epithelium of the pancreatic ductal system and are characterized by intraductal papillary growth and abundant mucin production, leading to ductal dilatation. Ø IPMNs are classified on the basis of site of origin of the pancreatic ductal system: main-duct IPMN; side-branch IPMN; and mixed IPMN involving both the main duct and side branches .
4
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Ø IPMNs occur slightly more commonly in men, with a mean age of occurrence of 65 years. they are symptomatic, presentations include abdominal pain, weight loss, pancreatitis, and pancreatic insufficiency.
Cystic Lesions of the Pancreas
1
Introduction
Ø The cystic lesions of the pancreas are relatively common findings (ranging from 2.4% to 24%); Ø Cystic lesions of来自百度文库the pancreas may range from benign to malignant and include both primary cystic lesions of the pancreas and solid neoplasms undergoing cystic degeneration.
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Side-branch IPMNs can have two different imaging appearances: a macrocystic pattern, in which there is a unilocular or multilocular cyst with few septa, and a microcystic pattern, in which multiple thin septa separate numerous fluid-filled spaces.
6
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Main-duct IPMN. (1)CT image demonstrates diffuse irregular dilatation of the main pancreatic duct with heterogeneous intraductal densities (arrow). (2) MRCP demonstrates a dilated main pancreatic duct with areas of irregular stenosis (arrows).
8
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Ø At CT, Side-branch IPMNs usually appear as hypoattenuating heterogeneous lesions and are classically located in the uncinate process, but they can be found anywhere in the pancreas. Ø At MR, side-branch IPMNs usually appear as small round or oval lobulated masses. A connection to the pancreatic duct is often demonstrated on cross-sectional images. Approximately 30% of sidebranch IPMNs are multifocal.
5
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Ø At CT, a main-duct IPMN may demonstrate diffuse or segmental dilatation of the main pancreatic duct. Ø At MR, a main-duct IPMN may demonstrate diffuse or segmental ductal dilatation, with hypointense T1 and hyperintense T2 signal. Mural nodules, mucin globules, or a dilatated major or minor papilla bulging into the duodenal lumen may be seen. Parenchymal atrophy may also be present.
2
Introduction
Ø The primary cystic lesions of the pancreas include intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, serous cystadenomas, pseudocysts, and true epithelial cyst. Ø The solid neoplasms undergoing cystic degeneration include neuroendocrine tumors, solid pseudopapillary neoplasms, and, rarely, adenocarcinoma and its variants.
3
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Ø IPMNs originate from the mucinous epithelium of the pancreatic ductal system and are characterized by intraductal papillary growth and abundant mucin production, leading to ductal dilatation. Ø IPMNs are classified on the basis of site of origin of the pancreatic ductal system: main-duct IPMN; side-branch IPMN; and mixed IPMN involving both the main duct and side branches .
4
Intraductal Papillary Mucinous Neoplasm (IPMNs)
Ø IPMNs occur slightly more commonly in men, with a mean age of occurrence of 65 years. they are symptomatic, presentations include abdominal pain, weight loss, pancreatitis, and pancreatic insufficiency.
Cystic Lesions of the Pancreas
1
Introduction
Ø The cystic lesions of the pancreas are relatively common findings (ranging from 2.4% to 24%); Ø Cystic lesions of来自百度文库the pancreas may range from benign to malignant and include both primary cystic lesions of the pancreas and solid neoplasms undergoing cystic degeneration.