CT Scanning Diagnosis Of Cystic (Solid) Lesions Of Pancreas

Objective To evaluate CT scanning in the diagnosis of cystic(solid) lesions of pancreasMethods CT features in 28 patients with pancreatic cystic(solid) lesions were retrospectively analyzed. Of these 28 cases ,13 cases were pathologically-proved, 15 cases were diagnosed by clinic and image . The spiral CT findings were obtained by using pre-contrast and post-contrast scanning(including arterial and portal venous phase).slice:5.0-7.5cm,pitch radio:1.375:1, matrix:512× 512.Results The results of CT features in 28 patients with pancreatic cystic(solid) lesions as follows:1, 8 cases with pancreatic pseudocyst: There were pancreatitis history in 7 cases. The diameter of cysts ranged froml.0~15.0cm, presenting as round or oval in shape. There was simple cyst in pancreatic tail zone after the tail removed. The cysts localized in the pancreatic head in 4 cases, in the pancreatic body-tail junction in 4 cases. Cystic walls were thick in 3 cases, thin in 5 cases. All the cysts were not enhanced. There was calcification in wall in 1 case.2, 3 cases with real cyst: The lesion localized in the pancreatic head, with polycyst in 1 case. The lesions localized in the whole pancreas with polycyst pancreas, and the size of the cysts was various. The lesion localized in the pancreatic tail zone with simple cyst. The diameter of the cysts ranged from 0.5cm~6.0cm.There were no pancreatitis history in 3 cases.3, 3 cases with serous cystadeoma: All the three tumors localized in the pancreatic head-neck junction and one of the tumors extended thepancreatic body. The diameter ranged from 2.2-15.Ocm.All the tumors presented as round and separation leaf in shape. There were many microcysts in the tumors and presented as honeycomb, and there was smooth separation among microcysts . The size of cystic lesions ranged from 0.2~2cm in diameter. The separation and the solid part marked enhancement on post-contrast CT scan4, 3 cases with mucinous cystadenocarcinoma: The lesions localized in the pancreatic body-tail junction in 1 case and in the pancreatic heads in 2cases. The diameter ranged from 2.5cm~10cm. 2 tumors appeared as simple cystic lesions. Cystic walls were thin and irregular, with projections of the inner wall, and demonstrated iso-attenuation in the arterial phase and portal venous phase on post-contrast CT scan. 1 tumor appeared as polycystic lesions, the size of lesions was various, with visible big separation in the cyst. Irregular thick wall was seen. The cyst wall and solid part of lesions were moderately enhanced. Infiltration in the surroundings was seen, and carcinomatous embolus was seen in the portal venous, and there were increscend lymph nodes in retroperitoneal zone.5, 3 cases with solid-psuedopapillary tumors: The tumors localized in the pancreatic head in 3 cases. There were solid and cystic structures in the neoplasm, the solid portions demonstrated hypo- or iso-attenuation on plain CT, slight enhancement in the arterial phase and marked enhancement in the portal venous phase on post-contrast CT scan. The cystic portions appeared hypo-attenuation on both pre- and post-contrast views. Most tumors presented as round or oval in shape and complete envelope in peripheral solid portion, and well-defined margins on post-contrast images. There was no associated dilatation of the common bile duct or pancreatic duct.6, 2 cases with cystic degeneration of pancreatic carcinoma: The diameter ranged from 3.0-8.Ocm. The lesion localized in the pancreatic head in lease.There were solid and cystic structures in the neoplasm. The solid portions demonstrated hypo- attenuation on plain CT scan. The part of cystic degeneration appeared hypo-attenuation on both pre- and port-contrast views. Irregular thick wall was seen, and demonstrated hypo- and iso-attenuation inthe arterial phase and portal venous phase respectively. IN another case, the lesion localized in the pancreatic body-tail junction, with polycystic lesions, the size of cystic part was various. Irregular thick walls were seen. The CT features on post-contrast CT were the same as above mentioned. Infiltration in the surroundings was seen. There were increscend lymph nodes in the retroperitoneal zone.7> 3 cases with cystic nonfunctioning endocrine tumors of the pancreas: The tumor localized in the pancreatic head in lease,in the pancreatic tail in 2 cases. The diameter ranged from 5.0-9.4 cm. There were solid and cystic structures in the neoplasm. The solid portions and envelope demonstrated heterogenous in the arterial phase, and more marked enhancement in the portal venous phase on post-contrast CT scan.8> 3 cases with pancreatic cyst with local chronic pancreatitis and dilated pancreatic duct: The 2 cases appeared as polycystic lesions in the whole pancreas, the size of lesions was various, the diameter ranged from 0.3~2cm, cystic walls were thin, without calcification. Pericyst pancreas tissue atrophied. There was a local inflammatory mass in the pancreatic head with well-defined margins. Many microcysts were seen. The predominant solid part marked enhanced.Conclusion: 1.The whole cystic(solid) lesions of pancreas were found on the the CT image view and diagnosed by accurate localization and quantity.2. CT differential diagnosis was well done among cyst ,cystic tumor and local inflammatory mass.3. CT differential diagnosis plus clinical data were well done between the real cyst and pseudocyst.4. By overall observation and analysis of the imaging signs plus clinical data, property of cystic(solid) tumors and pathologic type were analysed to most extend.