Objective To investigate the imaging features and pathological basis of pancreatic serous cystadenoma(PSC),to analyze the causes of misdiagnosis,and to summarize the preventive measures.Methods The clinical data and CT image features of 22 patients with PSC confirmed by surgical pathology and misdiagnosed as other lesions by multi-slice spi-ral CT before surgery from 2017 to 2023 were retrospectively analyzed,and compared with pathological HE staining.Methods Among the 22 patients,7 presented with abdominal pain,1 presented with nausea and vomiting,and the other 14 patients were accidentally found during physical examination,including 10 cases of microcystic type,8 cases of oligocystic type,3 ca-ses of mixed type,and 1 case of parenchymal type.The lesion was located in the head and neck of the pancreas in 8 patients and in the tail of the body in 14 patients,including lobulation in 13 patients,central scar in 2 patients,calcification in 5 pa-tients,and upper pancreatic duct dilatation in 5 patients.After enhancement,3 cases were significantly strengthened,5 cases were moderately strengthened,6 cases were mildly strengthened,and 8 cases were not strengthened.In 13 cases,PSC showed lobulated contour,clear boundary,honeycomb or polycystic structure,and no communication with pancreatic duct.Two pa-tients with PSC showed internal fiber scar,and 5 patients showed calcification and other characteristic image manifestations.There was misdiagnosis as mucinous cystadenoma in 5 patients,neuroendocrine tumor in 5 patients,solid pseudopapilloma in 4 patients,indeterminable tumor in 3 patients,pseudocyst in 2 patients,retention cyst in 1 patients,intraductal papilloma in pancreas in 1 patient,and pancreatic cancer in 1 patient.Misdiagnosis lasted from 7 to 180 d.All patients were treated with surgery and confirmed by postoperative pathological examination.There was no recurrence during follow-up.Conclusion There are several differences in the imaging manifestations of different types of PSC,but in the meantime,there are some com-mon imaging characteristics.For atypical cases,diagnosis using CT is difficult and the misdiagnosis rate is high,so it is nec-essary to improve the understanding of the disease and closely combine the clinical history to improve the diagnostic accuracy.
关键词
囊腺瘤,浆液/误诊/囊腺瘤,黏液/神经内分泌瘤/实性假乳头状瘤/胰腺导管内乳头状瘤/胰腺肿瘤
Key words
Cystadenoma,serous/Misdiagnosis/Cystadenoma,mucinous/Neuroendocrine tumors/Solid pseudo-papilloma/Intraductal papilloma of pancreas/Pancreatic Neoplasms
维普
万方数据