DOI QR코드

DOI QR Code

췌장 낭성 종양의 영상학적 감별

Radiologic Findings of Pancreatic Cystic Neoplasms

  • 홍성숙 (순천향대학교 의과대학 순천향대학교 서울병원 영상의학과)
  • Hong, Seong Sook (Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine)
  • 발행 : 2014.09.01

초록

With the widespread use of radiologic modalities such as ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI), cystic neoplasms of the pancreas are being increasingly detected; however, developing an accurate characterization and making a differential diagnosis are difficult because of their overlapping morphologic characteristics. Serous cyst adenoma is a common benign neoplasm that is typically observed as a multi-cystic mass or lobulated cyst with or without internal septation. In comparison, mucinous cystic neoplasms appear as smooth cystic tumors with or without internal septation. Finally, intraductal papillary mucinous neoplasms of the pancreas are pleomorphic cystic lesions or clubbed fingerlike tubular structures. These typical imaging findings can help clinicians differentiate cystic neoplasms of the pancreas.

키워드

참고문헌

  1. Wolfman NT, Ramquist NA, Karstaedt N, Hopkins MB. Cystic neoplasms of the pancreas: CT and sonography. AJR Am J Roentgenol 1982;138:37-41. https://doi.org/10.2214/ajr.138.1.37
  2. Visser BC, Yeh BM, Qayyum A, Way LW, McCulloch CE, Coakley FV. Characterization of cystic pancreatic masses: relative accuracy of CT and MRI. AJR Am J Roentgenol 2007;189:648-656. https://doi.org/10.2214/AJR.07.2365
  3. Sainani NI, Saokar A, Deshpande V, Fernandez-del Castillo C, Hahn P, Sahani DV. Comparative performance of MDCT and MRI with MR cholangiopancreatography in characterizing small pancreatic cysts. AJR Am J Roentgenol 2009;193:722-731. https://doi.org/10.2214/AJR.08.1253
  4. Demos TC, Posniak HV, Harmath C, Olson MC, Aranha G. Cystic lesions of the pancreas. AJR Am J Roentgenol 2002;179:1375-1388. https://doi.org/10.2214/ajr.179.6.1791375
  5. Sahani DV, Kambadakone A, Macari M, Takahashi N, Chari S, Fernandez-del Castillo C. Diagnosis and management of cystic pancreatic lesions. AJR Am J Roentgenol 2013;200:343-354. https://doi.org/10.2214/AJR.12.8862
  6. Laffan TA, Horton KM, Klein AP, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol 2008;191:802-807. https://doi.org/10.2214/AJR.07.3340
  7. Lee HJ, Kim MJ, Choi JY, Hong HS, Kim KA. Relative accuracy of CT and MRI in the differentiation of benign from malignant pancreatic cystic lesions. Clin Radiol 2011;66:315-321. https://doi.org/10.1016/j.crad.2010.06.019
  8. Zhang XM, Mitchell DG, Dohke M, Holland GA, Parker L. Pancreatic cysts: depiction on single-shot fast spin-echo MR images. Radiology 2002;223:547-553. https://doi.org/10.1148/radiol.2232010815
  9. Sahani DV, Sainani NI, Blake MA, Crippa S, Mino- Kenudson M, del-Castillo CF. Prospective evaluation of reader performance on MDCT in characterization of cystic pancreatic lesions and prediction of cyst biologic aggressiveness. AJR Am J Roentgenol 2011;197:W53-61. https://doi.org/10.2214/AJR.10.5866
  10. Sainani NI, Saokar A, Deshpande V, Fernandez-del Castillo C, Hahn P, Sahani DV. Comparative performance of MDCT and MRI with MR cholangiopancreatography in characterizing small pancreatic cysts. AJR Am J Roentgenol 2009;193:722-731. https://doi.org/10.2214/AJR.08.1253
  11. Kawamoto S, Lawler LP, Horton KM, Eng J, Hruban RH, Fishman EK. MDCT of intraductal papillary mucinous neoplasm of the pancreas: evaluation of features predictive of invasive carcinoma. AJR Am J Roentgenol 2006;186:687-695. https://doi.org/10.2214/AJR.04.1820
  12. Procacci C, Carbognin G, Accordini S, et al. CT features of malignant mucinous cystic tumors of the pancreas. Eur Radiol 2001;11:1626-1630. https://doi.org/10.1007/s003300100855
  13. Kim YC, Choi JY, Chung YE, et al. Comparison of MRI and endoscopic ultrasound in the characterization of pancreatic cystic lesions. AJR Am J Roentgenol 2010;195:947-952. https://doi.org/10.2214/AJR.09.3985
  14. Cohen-Scali F, Vilgrain V, Brancatelli, et al. Discrimination of unilocular macrocystic serous cystadenoma from pancreatic pseudocyst and mucinous cystadenoma with CT: initial observations. Radiology 2003;228:727-733. https://doi.org/10.1148/radiol.2283020973
  15. Handrich SJ, Hough DM, Fletcher JG, Sarr MG. The natural history of the incidentally discovered small simple pancreatic cyst: long-term follow-up and clinical implications. AJR Am J Roentgenol 2005;184:20-23. https://doi.org/10.2214/ajr.184.1.01840020
  16. Kim SY, Lee JM, Kim SH, et al. Macrocystic neoplasms of the pancreas: CT differentiation of serous oligocystic adenoma from mucinous cystadenoma and intraductal papillary mucinous tumor. AJR Am J Roentgenol 2006;187:1192-1198. https://doi.org/10.2214/AJR.05.0337
  17. Kim HJ, Lee DH, Ko YT, Lim JW, Kim HC, Kim KW. CT of serous cystadenoma of the pancreas and mimicking masses. AJR Am J Roentgenol 2008;190:406-412. https://doi.org/10.2214/AJR.07.2808
  18. Johnson CD, Stephens DH, Charboneau JW, Carpenter HA, Welch TJ. Cystic pancreatic tumors: CT and sonographic assessment. AJR Am J Roentgenol 1988;151:1133-1138. https://doi.org/10.2214/ajr.151.6.1133
  19. Inan N, Arslan A, Akansel G, Anik Y, Demirci A. Diffusion-weighted imaging in the differential diagnosis of cystic lesions of the pancreas. AJR Am J Roentgenol 2008;191:1115-1121. https://doi.org/10.2214/AJR.07.3754
  20. Gupta R, Mortele KJ, Tatli S, et al. Pancreatic intraductal papillary mucinous neoplasms: role of CT in predicting pathologic subtypes. AJR Am J Roentgenol 2008;191:1458-1464. https://doi.org/10.2214/AJR.07.3302