自身免疫性胰腺炎影像特征的显示：MRI与CT对照  

Imaging characteristics of autoimmune pancreatitis： MRI versus

作　　者：谭晔[1] 方金洲 杨正汉[1] 姜蕾[1] 唐维林[3] 张铎[4] 李光 张骏[6] 叶晓华[1] 张旻[1] 周诚[1] 

机构地区：[1]卫生部北京医院暨北京大学第五临床医学院放射科,100730 [2]浙江省巨化集团医院放射科 [3]齐齐哈尔医学院附属医院MR室 [4]吉林省北华大学医学院附属医院放射科 [5]湖北省襄樊市第一医院磁共振室 [6]湖北省新华医院放射科

出　　处：《中华放射学杂志》2009年第8期835-839,共5页Chinese Journal of Radiology

摘　　要：目的比较CT与MRI对自身免疫性胰腺炎（AIP）影像特征的显示能力。方法回顾性分析23例经组织学或类固醇激素治疗证实的AIP患者的MRI及CT资料，CT与MRI对各项AIP影像特征显示能力的比较采用配对资料卡方检验。结果本组23例AIP患者中，CT与MR均显示胰腺肿大21例，其中弥漫肿大16例，局部肿大5例。CT与MR在显示病变区平扫密度或信号异常（分别显示4和23例）、病变区延迟强化（分别显示10和19例）、病变周围假包膜结构（分别显示5和16例）、胰管弥漫性不规则狭窄（分别显示0和8例）方面，MRI的显示率高于CT（χ^2值分别为17．05、7．11、9．09、6．12，P值均〈0．01）。在显示增强扫描动脉期灌注降低（分别显示16和21例）和胆总管胰腺段狭窄（分别显示14和18例）方面，两者差异无统计学意义（χ^2值分别为3．20、2．25，P值均〉0．05）。结论在显示病变区平扫密度或信号异常、病变区延迟强化、病变周围假包膜结构、胰管弥漫性不规则狭窄等方面，MRI的显示率高于CT。而对于AIP的其他影像特征的显示，尤其是对于胰腺肿大的显示，MRI的显示率与CT相似。Objective To compare CT and MRI for demonstrating imaging characteristics of autoimmune pancreatitis （AIP）. Methods Both CT and MR imaging were performed on 23 patients with AIP, proved histopathologically or clinically by corticosteroid trial. Findings including presence of pancreatic enlargement, density or signal intensity abnormalities on unenhanced CT or MRI, decreased enhancement on arterial phase, moderate enhancement on delayed phase, capsule-like rim, diffuse irregular narrowing of main pancreatic duct and common bile duct stricture were retrospectively analyzed. The frequencies of demonstrating these imaging features were compared between CT and MRI, using the paired Chi-square tests. Results Of the 23 cases, CT and MRI both showed pancreatic enlargement in 21 cases, diffuse （n = 16 ） and focal （ n = 5 ）. Density or signal intensity abnormalities on non-enhanced scans （ CT vs MRI ： 4 vs 23 ）, moderate enhancement on delayed images （ CT vs MRI ： 10 vs 19 ） , capsule-like rim （ CT vs MR] ： 5 vs 16 ） and diffuse irregular narrowing of main pancreatic duet （CT vs MR] ： 0 vs 8 ） were more frequently seen on MRI than on CT with statistically significant difference （χ^2 were 17. 05,7. 11,9. 09,6. 12 respectively, P 〈 0. 01 ）. Decreased enhancement on arterial phase of dynamic imaging （ CT vs MRI ： 16 vs 21 ） and stricture of distal common bile duet （CT vs MRI ： 14 vs 18 ） were slightly more frequently detected on MRI than on CT, but no statistically significant difference existed （ χ^2 were 3.20 and 2.25 respectively, P 〉0. 05）. Conclusion For demonstrating density or signal intensity abnormalities on non-enhanced scans, enhancement on delayed phase, capsule-like rim and irregular narrowing of pancreatic duct, MRI is superior to CT. As for other imaging features, especially pancreatic enlargement, MRI is comparable to CT.

关 键 词：胰腺炎 自身免疫疾病 体层摄影术 X线计算机 磁共振成像 

分 类 号：R686[医药卫生—骨科学]