Diagnosis And Differential Diagnosis Of Pancreatic Mucinous Cystic Tumors By Using MSCT

Objective:To improve the diagnostic and differential diagnostic capability of pancreaticmucinous cystic neoplasms (MCN) by investigating their MSCT features, and to provideinstructions for the clinical treatment.Materials and Methods:A total of19patients with pathologically confirmed pancreatic MCN were collected,10of whom were mucinous cystadenoma (MCA),9were mucinous cystic carcinoma(MCC) and15were pancreatic serous cystadenoma (SCA). All patients have integralclinical data. A series of patient information and tumor property were studied, includingtumor location, shape, growth pattern, border, size, thickness of cyst wall, number of cysts,solid nodules, septa thickness, intratumoral scar, calcification, communication with thepancreatic duct, dilatation of the main pancreatic duct, distal pancreatic atrophy, concurrentpancreatitis and pancreatic calcification, dilated common bile duct, tumor surrounded byblood vessels, lymph nodes, infiltration of other organs or metastasis. All statistical testswere performed on SPSS19.0, P <0.05was considered statistically significant.Results:19patients had single tumor (19/19,100%),13tumors were located in thepancreatic body or tail (13/19,68.4%),12were round or oval (12/19,63.2%), the diameterof single tumors range from2.3to13.5cm (mean5.9cm),16patients have lesions withdiameter longer than3cm (16/19,84.2%),10patients with exophytic lesions (10/19,52.6%),lesions in17patients were well demarcated (17/19,89.5%), cyst wall thickness in13patients were uneven (13/19,68.4%),10patients with thin-walled cyst (10/19,52.6%),14cases were polycystic (14/19,73.7%),16tumors had large sacs (16/19,84.2%),9tumors had intracapsular solid nodules (9/19,47.4%),14tumors had intracapsular septa(14/19,73.9%),17tumors had no central scar (17/19,89.5%),8tumors showedintratumoral calcification (8/19,42.1%),7tumors with calcification located in the peripheral zone (7/8,87.5%),19patients showed no communication with the pancreaticduct (19/19,100%),10patients showed varying degree of dilated pancreatic duct (10/19,52.6%),4patients showed atrophy of distal pancreas (4/19,21.1%),2tumors located in thepancreatic head and neck showed choledochectasia (2/19,10.5%),6tumors weresurrounded by the adjacent vessels (6/19,31.6%),4patients showed lymphadenectasis(4/19,21.1%),3patients were concurrent with metastasis (3/19,15.8%). ComparedMCA (n=10) with MCC group (n=9), there were significant differences in solid nodules(P=0.023), wall thickness (P=0.019), lymphadenectasis (P=0.033). Compared MCA(n=10) with SCA group (n=15), there were significant differences in central scar (P=0.018), thickness of intracapsular septa (P=0.033).Conclusions:Pancreatic MCN has specific clinical and MSCT features (middle-aged women,located in pancreatic body and tail, round or oval, well-demarcated, uneven cyst wall, largesac, intracapsular septa, etc.). MSCT manifestation combined with relevant clinical datawould provide great value in diagnosis and differential diagnosis of pancreatic MCN.