應如何判斷胰臟腫瘤是否需立即切除？MRI報告分析與治療建議-肝膽腸胃科

請問胰臟MRI報告,此瘤是否需要切除?？

請問家人最近因腹部劇烈疼痛(反射到背部)而照MRI檢查,發現胰臟有腫瘤,因為負責做MRI的醫院說看起來是血管瘤,等3個月後再照一次追蹤檢查即可,但是帶影像報告到另一家醫院,醫生立即判定是胰臟神經內分泌瘤,要我們立刻安排時間切除,因為這是大手術且不能用微創,想請教各位這份書面報告是寫什麼?是否該立即開刀切除?Exam description 檢查名稱 :MR Abdomen-liver&MRCPImpression 影像臆斷 :1. Suspect a 2.5*1.7*2.0cm hemangioma at the lower margin of the pancreatic neck. Ddx:other vascular tumors, islet cell tumor but less likely.2. Chronic pancreatitis with pancreas atrophy and dilated P-duct.3. Gallbladder sludgesFindings 檢查發現 :MRI of abdomen and pelvis without/with Gd-DTPA contrast medium administration reveasl :1. There is a 2.5*1.7*2.0cm nodule located at the lower margin of the pancreatic neck,out pouching into the lesser sac. The lesion shows clear margin with the pancreas. The lesion shows high T2 signal intensity(Se/Im: 3/16) and low T1 signal intensity (Se/Im : 8/16) relative to the normal pancreas. In the dynamic study, it shows irregular hyperenhancement in the arterial phase (Se/Im : 15/20) and homogenous, persistent enhancement in the venous and delay phase (Se/Im: 16-17/20). More in favor of hemangioma, ddx: other vascular tumors, islet cell tumor but less likely.2. No lesion shows diffusion restriction is found in this examination.3. Mild P-duct dilatation of the main duct and some secondary ducts. Mild atrophy of the pancreas. In favor of chronic pancreatitis.4. Gallbladder soudges5. A small right renal cyst.6. No definite lesion is found in the liver.7. No IHDs, CBD dilatation