Imaging features of cystic tumors of the pancreas with multi-slice CT:compared with pathology

Objective: To explore the imaging features and diagnostic value of cystic tumors of the pancreas with multi-slice CT(MSCT). Methods: Twenty-one patients confirmed by surgery and pathology were studied retrospectively,including serous cystadenoma(n=5),mucinous cystic neoplasm(n=10,mucinous cystadenoma 5 cases,mucinous cystadenocarcinoma 5 cases),intraductal papillary mucinous tumor(n=3),solid and pseudopapillary tumor(n=3). They all underwent the pre-and post-enhanced multi-phase CT examination with Siemens sensation 4-or 16-slice scanner. Results: ①Five cases of serous cystadenoma all occured in women,of which 4 tumors located in the head of the pancreas and manifested as a multilocular sponge-like mass. Central calcification was seen in 1 case. ②In 10 patients with mucinous cystic neoplasm,7 cases were female,8 cases involved the body and tail of the pancreas. Tumors were multilocular or unilocular. Benign cystic neoplasm(cystadenoma) showed a well-defined border with no or small intramural nodule,whereas malignant cystic neoplasm(cystadenocarcinoma) displayed a ill-defined border with larger intramural nodule and peripancreatic infiltration. The dilation of the bile duct and pancreatic duct or distal metastasis could be seen. ③In 3 cases with intraductal papillary mucinous tumor,2 were women,and in 2 cases the lesion located at the head of the pancreas. Cystic tumors had the grape-like locular appearance and communicated with the dilated pancreatic duct. ④In 3 cases of solid and pseudopapillary tumor,2 were women which all located in the body and tail of the pancreas. They were young or middle aged. The tumors were well circumscribed,and may be enclosed by thick fibrous capsule. The proportion of the solid part to cystic part of the tumor was changeable. Solid part was heterogeneously enhanced during the arterial phase with progressive fill-in to the lesion during the late phases. Conclusion: MSCT can reveal the pathologic characteristics of cystic tumors of the pancreas and play an important role in diagnosis and differential diagnosis.