自身免疫性胰腺炎的MRI表现研究  

Autoimmune pancreatitis: study of MRI manifestation

作　　者：倪瑞军[1] 许顺良[2] 阮翎翔[1] 王伯胤[3] 

机构地区：[1]浙江大学医学院附属第一医院,浙江杭州310003 [2]浙江大学医学院附属第一医院放射科,310003 [3]绍兴市人民医院,浙江绍兴312000

出　　处：《中国临床医学影像杂志》2011年第9期631-636,共6页Journal of China Clinic Medical Imaging

摘　　要：目的:研究自身免疫性胰腺炎(AIP)的MR表现。方法:回顾性分析8例AIP患者的MR资料,8例均有MR平扫及动态增强扫描资料;分析病变胰腺的形态、部位以及在平扫抑脂和非抑脂的T1WI、T2WI上的信号特点、动态增强扫描强化特点,观察病变胰腺的内部结构,定量分析动态增强扫描病变胰腺MR信号强度的变化规律,并与正常对照组(n=25)进行比较。结果:5例AIP表现为胰腺弥漫增大,3例表现为胰腺局限性肿大;6例可见"假包膜"征;病变胰腺区未见主胰管显影。4例合并胆管扩张。在非抑脂T2WI、T1WI上病变胰腺呈低信号;在抑脂T1WI上病变信号欠均匀,信号强度高低不一。动态增强扫描时有6例AIP病变胰腺内见索条状、细小结节状先期强化影;8例均呈渐进性强化,在平扫期、动脉期,AIP组信号低于对照组,至门脉期、延迟期AIP组信号强度高于对照组。结论:自身免疫性胰腺炎在MRI上有特征性表现,抑脂T1WI、动态增强扫描对其诊断具有重要价值,多数AIP病例可以通过MR检查确诊。Objective： To investigate the MR imaging findings of autoimmune pancreatitis（AIP）.Methods： The MR data of 8 patients with AIP were retrospectively reviewed.Plain MR and dynamic contrast-enhanced three-phase MR scanning was performed on 8 patients.Fat-suppressed T2WI,T1WI,in-and out-phase T1WI and dynamic contrast-enhanced data were analyzed,focusing on signal intensity of abnormal pancreas parenchyma,enhancement patterns of the abnormal pancreas and microstructure alteration.The signal intensity value of abnormal pancreas parenchyma on plain-scanning and each phase of dynamic contrast-enhanced scanning were measured,compared to that of controls（n=25,with normal pancreas）.Results： Five patients showed diffuse swelling of the pancreas and 3 patients showed segmental enlargement of pancreas.6 patients showed psuedocapsule like around the pancreatic body and tail.Main pancreatic duct in abnormal pancreas were invisible.The signal intensity on each sequence was lower than that of normal pancreas： abnormal pancreas showed homogeneous hypointensity on fat-suppressed（or not） T2WI and not fat-suppressed T1WI,and heterogeneous multiscale hypointensity on fat-suppressed T1WI;Some funicular slightly hyperintensity area could be seen in the abnormal pancreas on fat-suppressed T1WI.Funicular and micronodular enhanced area could be seen in 6 patients with AIP ahead of time.Progressively enhancement was found in 8 patients with AIP,different from the controls.Conclusion： There is typical MR imaging features of AIP.Fat-suppressed T1WI and MR dynamic contrast-enhanced scanning play an important role in discovering the alteration of microstructure of AIP.AIP can be diagnosed correctly through MR examination.

关 键 词：胰腺炎 磁共振成像 

分 类 号：R657.51[医药卫生—外科学] R445.2[医药卫生—临床医学]