Benign Pankreas Hastalıklarının Tanısında Görüntüleme
Özet
Benign pankreas hastalıklarının tanısında kullanılan radyolojik görüntüleme yöntemleri ve bu hastalıkların morfolojik özellikleri, operatif tedavi planlamasında kritik bir öneme sahiptir. Pankreasın retroperitoneal yerleşimi ve çevre vasküler yapılarla olan yakın ilişkisi nedeniyle lezyonların doğru tanımlanması gerekir. Rutin uygulamada ilk seçenek olan ultrasonografi (USG) bazı kısıtlılıklara sahipken; çok kesitli bilgisayarlı tomografi (BT) ve manyetik rezonans görüntüleme (MRG/MRKP), lezyon karakterizasyonu ile biliyer anatominin değerlendirilmesinde temel yöntemlerdir. Pankreas divisum ve anuler pankreas gibi konjenital anomalilerin yanı sıra; revize Atlanta kriterlerine göre intertisyel ödematöz ve nekrotizan olarak sınıflandırılan akut pankreatit, kronik pankreatit, otoimmün pankreatit ve groove pankreatit gibi inflamatuar patolojiler görüntüleme bulgularıyla açıklanmaktadır. Ayrıca, malignite potansiyeli taşıyan intraduktal papiller müsinöz neoplazm (IPMN), seröz kistik neoplazm (SKN), müsinöz kistik neoplazm (MKN) ve solid psödopapiller neoplazi (SPN) gibi benign tümöral lezyonların ayırıcı tanı kriterleri ve yönetimleri detaylandırılmaktadır.
Radiological imaging modalities used in the diagnosis of benign pancreatic diseases and their morphological characteristics hold critical importance in operative treatment planning. Due to the retroperitoneal location of the pancreas and its close relationship with surrounding vascular structures, accurate identification of lesions is essential. While ultrasonography (USG) is the first choice in routine practice despite its limitations, multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI/MRCP) serve as the primary methods for evaluating lesion characterization and biliary anatomy. Congenital anomalies such as pancreas divisum and annular pancreas are reviewed alongside inflammatory pathologies, including acute pancreatitis—classified as interstitial edematous or necrotizing according to the revised Atlanta criteria—chronic pancreatitis, autoimmune pancreatitis, and groove pancreatitis. Furthermore, differential diagnosis criteria and management strategies for benign tumoral lesions with malignant potential, such as intraductal papillary mucinous neoplasm (IPMN), serous cystic neoplasm (SCN), mucinous cystic neoplasm (MCN), and solid pseudopapillary neoplasm (SPN), are thoroughly detailed.
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