旨在探讨具有组织学大导管模式的胰腺导管腺癌（PDAC）的影像学特征。我们的研究纳入了 37 例经手术证实具有组织学大导管模式的 PDAC 患者（平均年龄，66.5 岁；22 名女性），其影像学特征分为四类类型：I型，固体块； II型，以囊性肿块为主，囊内有实性成分； III型，主要为实性肿块，伴瘤内囊肿； IV 型，实性肿块伴瘤周滞留囊肿或假性囊肿。两名放射科医生独立分析了 CT 和 MRI 图像的形态类型、是否存在主胰管（MPD）突然切断、邻近血管侵犯、扩散限制，并达成共识。在 CT 上，26 名患者（70.3%）患有 I 型肿瘤， 5 名（13.5%）为 II 型，3 名（8.1%）为 III 型，3 名（8.1%）为 IV 型。在 26 例 CT 上显示为 I 型肿瘤的患者中，16 例 MRI 上显示肿瘤在实性肿块内有多个瘤内囊肿，随后被分类为 III 型。因此，MRI 上 10 名患者 (27.0%) 被归类为 I 型，5 名患者 (13.5%) 为 II 型，19 名患者 (51.7%) 为 III 型，3 名患者 (8.1%) 为 IV 型。在 37 例患者中，27 例 (73.0%) 出现 MPD 突然中断，15 例 (40.5%) 出现邻近血管侵犯，25 例 (67.6%) MRI 出现弥散受限。是具有组织学大导管模式的 PDAC 的特征性影像学表现，并将其与传统 PDAC 或其他囊性胰腺肿瘤区分开来。放射科医生应熟悉具有组织学大导管模式的 PDAC 的各种影像学特征，并应意识到它可能模仿其他胰腺肿瘤。胰腺实体性或囊性肿瘤。具有组织学大导管模式的胰腺导管腺癌的影像学特征可分为四种类型。与 CT 上相比，这种病理在 MRI 上更常表现为以实性肿块为主并伴有瘤内囊肿。将 MRI 添加到 CT 可能有助于识别具有组织学大导管模式的胰腺导管腺癌。© 2024。作者，获得欧洲放射学会的独家许可。

To investigate the imaging features of pancreatic ductal adenocarcinoma (PDAC) with histological large duct pattern.Our study included 37 patients (mean age, 66.5 years; 22 women) with surgically proven PDAC with histological large duct pattern, whose imaging features were classified into four types: Type I, solid mass; Type II, predominantly cystic mass with intracystic solid components; Type III, predominantly solid mass with intratumoral cysts; and Type IV, solid mass with peritumoral retention cysts or pseudocysts. Two radiologists independently analyzed both CT and MRI images for the morphological type, presence of abrupt main pancreatic duct (MPD) cutoff, adjacent vascular invasion, diffusion restriction, and reached consensus.On CT, 26 patients (70.3%) had Type I tumors, five (13.5%) had Type II, three (8.1%) had Type III, and three (8.1%) had Type IV. Among the 26 patients with Type I tumors on CT, 16 had tumors with multiple intratumoral cysts within the solid mass on MRI and were subsequently classified as Type III. Accordingly, 10 patients (27.0%) were classified as Type I, five (13.5%) as Type II, 19 (51.7%) as Type III, and three (8.1%) as Type IV on MRI. Of the 37 patients, 27 (73.0%) had an abrupt MPD cutoff, 15 (40.5%) had adjacent vascular invasion, and 25 (67.6%) had diffusion restriction on MRI.Predominantly solid pancreatic masses with small intratumoral cysts visualized on MRI may be a characteristic imaging finding of PDAC with histological large duct pattern, and differentiate it from conventional PDAC or other cystic pancreatic tumors.Radiologists should be familiar with the various imaging features of PDAC with histological large duct pattern and should be aware that it may mimic other solid or cystic tumors of the pancreas.Imaging features of pancreatic ductal adenocarcinoma with histological large duct pattern can be classified into four types. This pathology more frequently appears as a predominantly solid mass with intratumoral cysts on MRI than on CT. Adding MRI to CT may help identify pancreatic ductal adenocarcinoma with histological large duct pattern.© 2024. The Author(s), under exclusive licence to European Society of Radiology.