Differential Radiology Diagnostics of Rare Cystic Pancreatic Lesions

Abstract

The purpose: to analyze the criteria and assess the possibilities of radiology methods in the diagnosis of rare cystic pancreatic neoplasms. Materials and methods: From 2004 to 2019 at A.V. Vishnevsky NMRC of Surgery 222 patients with suspected cystic pancreatic lesions were examined and treated, 15-80 years old, men - 59.9%. Radiology examination: ultrasound, multislice computed tomography (MSCT) and magnetic resonance imaging (MRI). 182 patients (82.0%) were operated. Morphology: intraductal papillary mucinous neoplasms (IPMN) - 96 (43.2%), solid pseudopapillary tumors (SPPT) - 50 (22.6%), cystic form of duodenal dystrophy (DD) - 72 (32.4%), cystic teratoma - 1 (0.45%), cystic lymphangioma – 1 (0.45%), echinococcosis – 2 cases (0.9%). Results: The article provides the differential diagnostic criterias for rare cystic pancreatic lesions. Complete radiology examination (ultrasound, MSCT, and MRI) makes it possible to diagnose and differentiate various forms of pancreatic cystic lesions. At suspected presence of a rare pancreatic lesion, the radiology preference should be given to MRI. Criteria for radiology diagnostics of the IPMN and DD cystic form have been well defined. The formulation of the SPPT diagnostic criteria requires the accumulation of a greater number of observations in one place and an analysis of the corresponding information. Anamnesis of the disease is an important supplement to the SPPT radiology diagnostics. Conclusions: A.V. Vishnevsky NMRC of Surgery (Moscow) has fifteen years experience in diagnosing and treating such rare forms of pancreatic cystic neoplasms as IPMN, SPPT, and the cystic form of DD. It should be pointed