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目的:比较CT和动态增强磁共振成像(MRI)诊断胰腺浆液性微囊性囊腺瘤(SMAP)的价值。方法:抽取2020年2月至2023年12月安康市人民医院收治的82例疑似SMAP患者的临床资料进行回顾性研究。所有患者术前均行CT和动态增强MRI检查，以手术病理结果作为金标准，分析两种检查方式对SMAP的诊断价值。分析SMAP的影像学表现。结果:CT检查肿块长径与病理检查结果比较差异未见统计学意义( P>0.05)，但动态增强MRI检查肿块长径与病理检查结果比较差异有统计学意义( P<0.05)。病理共检出阳性72例，阴性10例。CT检测SMAP的灵敏度、特异度、阳性预测值、阴性预测值和准确度均低于动态增强MRI( P均<0.05)。CT共检出阳性患者68例，其中真阳性62例。SMAP病灶在CT中呈低密度影，病灶边界清晰，囊壁呈不均匀厚度且粗大钙化，内部可见多发性微囊，中央呈放射状纤维化瘢痕。动态增强MRI检查阳性患者70例，其中真阳性69例。MRI图像可见病灶内有多个囊腔且大小不一，信号均为长T1长T2。病灶边界模糊不清，有纤维化瘢痕，与内部囊腔的分隔较为清晰，T1加权像、T2加权像及弥散加权成像均为低信号。增强扫描见远端胰管扩张，呈实性肿瘤。 结论:CT对SMAP病灶长径的评估更接近病理结果，但动态增强MRI对SMAP的诊断效能更高。

Objective:To compare the significance of computed tomography (CT) and dynamic contrast-enhanced magnetic resonance imaging (MRI) in the diagnosis of serous microcystic adenoma of pancreas (SMAP).Methods:A retrospective study was conducted on clinical data collected from 82 suspected SMAP patients admitted to Ankang People’s Hospital from February 2020 to December 2023. All patients underwent preoperative CT and dynamic contrast-enhanced MRI examinations. Taking surgical pathological results as the gold standard, the diagnostic value of the two examinations for SMAP was analyzed. And radiographic findings of SMAP were analyzed.Results:There was no difference in the major diameter of the tumor detected by CT examination and pathology ( P>0.05); however, there was a significant difference in the major diameter of the tumor detected by dynamic contrast-enhanced MRI and pathology ( P<0.05). Pathology examination identified 72 cases positive and 10 cases negative. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in diagnosis of SMAP were lower than those of dynamic contrast-enhanced MRI ( P<0.05). A total of 68 positive patients were detected out by CT, of which 62 cases were true positive. The CT examination on lesions of SMAP displayed low-density shadow, clear boundaries, uneven thickness and thick calcification of the cyst wall, multiple microcapsules inside, and radiating fibrotic scar in the center. Dynamic enhanced MRI examination identified 70 cases positive, including 69 true positive cases. MRI image displayed multiple cysts of varying sizes, long T1 and long T2 signals in the SMAP lesions, moreover, MRI examination displayed blurry boundary with fibrotic scars which was clear separated from the internal cystic cavity. T1 weighted imaging, T2 weighted imaging, and diffusion-weighted imaging of SMAP all showed low signal intensity. Enhanced scanning revealed distal pancreatic duct dilation, presenting as a solid tumor. Conclusions:CT has a comparable effect with pathology in predicting major diameter of SMAP lesions; however, dynamic enhanced MRI has higher diagnostic efficacy for SMAP.