AGA：胰腺假性囊肿的诊断及管理

The incidence of pancreatic cysts in the US population increases with age and may be as common as 25% in those older than 70 years. Pancreatic mucinous cystadenocarcinoma and pancreatic ductal carcinoma are rare. Using Surveillance, Epidemiology, and End Results database statistics, we estimate that a cyst seen incidentally on MRI has a 10 in 100,000 chance of being a mucinous invasive malignancy and a 17 in 100,000 chance of being a ductal cancer. The overall risk that an incidental pancreatic cyst is malignant is therefore very low. If a radiologist experienced in the accurate assessment of pancreatic cystic lesions reports no concerning features, then it should be safe to follow up the great majority of patients. MRI is the preferred surveillance imaging modality over computed tomography because MRI does not expose the patient to radiation and better demonstrates the structural relationship between the pancreatic duct and associated cyst. Also, MRI is less invasive than EUS. The follow-up interval of 1 and then 2 years is not based on any evidence but is believed to be reasonable given the small absolute risk of malignancy.