慢性胰腺炎的CT表现对治疗选择的意义  

CT pattern of chronic pancreatitis and its significance on the selection of treatment

作　　者：汪溪[1] 陈宽仁[1] 施维锦[2] 

机构地区：[1]连云港市第二人民医院普外科,江苏连云港222006 [2]上海交通大学医学院附属仁济医院普外科,上海200001

出　　处：《肝胆胰外科杂志》2008年第6期393-396,共4页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨慢性胰腺炎CT形态学分型及其对治疗选择的指导作用。方法回顾分析经治疗证实的59例慢性胰腺炎的CT影像和治疗方法,结合文献总结讨论不同病理形态改变的慢性胰腺炎在治疗方法选择上的区别。结果59例中27例(46%)表现为全胰腺萎缩伴不同程度胰实质钙化,采取内科保守治疗;7例为单或多发囊肿型(12%)表现为胰腺及其周围多发假性囊肿形成,对最长径大于5cm者行切开引流和吻合;7例(12%)表现为胰管狭窄或扩张,行胰管减压引流术;5例(8%)为表现为胰头胰腺局限性软组织样肿块,全部手术切除。13例(22%)为以上两种或以上的混合表现,以外科手术为主。对合并有胆道梗阻的病例做减压引流。结论慢性胰腺炎可分萎缩钙化型、假性囊肿型、胰管狭窄或扩张型、肿块型、混合型5型,CT形态学分型对治疗方案选择及明确病因有一定的意义。Objective To explore and discuss the classification of the morphological characteristics of chronic pancreatitis and its significance on the selection of treatment. Methods In fifty-nine patients with chronic pancreatitis, CT imaging characteristics and therapatic method were studied, focusing on its different pathological shape with different therapeutic methods. Results Twenty-seven of 59 patients （46%） showed all pancreas atrophy combined with different degrees of pancreatic calcification. All patients of this type were received conservative treatment. Seven of 59 （12%） showed single cyst and multi-cysts imagings within or around the pancreas. Incision drainage and anastomosis were used in the patients whose cyst diameter was larger than 5 cm; 7 of 59 （12%） had stricture or dilation of the pancreatic tube and all of them were undergone decompressing drainage; 5 cases （8%） showed localized mass like soft tissue at the pancreatic head and all of them were treated by surgical excision. Thirteen cases （22%） demonstated two or more than two kinds of mixed characteristics and mostly were undergone with surgical operation methods. The cases which combined with biliary obstruction were treated by decompressing drainage. Conclusion Chronic pancreatitis may be classified into 5 types in CT： atrophic calcified type; pseudo-cyst type; pancreas tube occlusion or dilated type; mass type and mixed type. The CT morphological classification has important significance on the choice of treatment and etiological diagnosis.

关 键 词：慢性胰腺炎 CT 分型 诊断 治疗 

分 类 号：R657.51[医药卫生—外科学]