Comparison of CT and MRI findings of different types of pancreatic Serous cystic neoplasm: combined with histopathology

Abstract

Objectives A comparative analysis of the imaging findings across different types Serous Cystic Neoplasm（SCN）was conducted, the objective is to delineate distinct image characteristics, thus enhancing diagnostic accuracy. Methods The retrospective analysis involved 65 patients diagnosed with Serous Cystic Neoplasm (SCN) confirmed by pathology. Patients were categorised into macrocystic, microcystic, mixed, and solid types based on morphology. A comparative analysis of the imaging findings across different SCN types was conducted, elucidating their respective imaging characteristics. Additionally, microscopic pathological observations were juxtaposed to discern disparities among the various SCN types. Results Age, lesion location, clinical symptoms, and underlying diseases did not exhibit significant differences among the various types of Serous Cystic Neoplasm (SCN) (P > 0.05). However, the volume of lesions in the mixed type was notably larger than that in the microcystic type (P < 0.05). Additionally, the CT values of the mixed and microcystic types were higher than those of the macrocystic type in precontrast scans (P < 0.05). The enhancement degree of the macrocystic type significantly differed from that of the mixed and microcystic types (P < 0.05). Notably, central fibrous scars were evident in mixed and microcystic SCN interiors, contrasting with the absence of such scars in macrocystic types (P < 0.05). While the proportion of calcification and pancreatic duct dilatation was higher in mixed and microcystic types. Electron microscopic revealed that macrocystic types featured large cyst cavities with thin fiber separation and few blood vessels, whereas microcystic types exhibited small cavities with a high number of fibers and visible scar tissue. Mixed types represented a combination of macrocystic and microcystic features. Solid types displayed very small cavities, high proportions of fibrous stroma, and rich blood vessels. Conclusion Differences in CT and MR findings among different types of SCN suggest a correlation with their pathological basis.