自身免疫性胰腺炎的CT表现研究  

Autoimmune pancreatitis:study of CT manifestation

作　　者：倪瑞军[1] 王伯胤[1] 许顺良[2] 阮翎翔[2] 

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

出　　处：《中国临床医学影像杂志》2011年第10期704-710,共7页Journal of China Clinic Medical Imaging

摘　　要：目的:研究自身免疫性胰腺炎(Autoimmune pancreatitis,AIP)的CT表现。方法:回顾性分析11例AIP患者的CT资料,11例均有CT平扫及动态增强扫描资料;分析病变胰腺的部位、形态及节段性AIP的病变胰腺与正常胰腺交界面(本文称作病变胰腺"前端",前端与病变胰腺最大径之间称为"前段")特征;定量分析AIP的平扫密度、动态增强扫描时病变胰腺强化模式,并与正常对照组(n=25)进行比较。结果:4例AIP表现为胰腺弥漫性肿大,7例表现为胰腺节段性肿大,病变胰腺长轴均与主胰管一致。7例节段性AIP中:病变前端细小、前段呈圆锥形2例;前端平直、前段呈梯形1例;前端呈圆弧形、前段呈"子弹头"状3例;另1例AIP一侧前段呈"子弹头"状,另一侧前段呈圆锥形。3例节段性AIP的大体外形呈纺缍形或梭形;3例节段性AIP病变胰腺边缘毛糙、中间段稍粗的长柱状;5例AIP呈腊肠状,其中1例为节段性AIP。平扫时11例AIP病变胰腺密度呈均匀的等偏低密度,动态增强扫描11例均呈渐进性强化,动脉期AIP组密度低于对照组,门脉期AIP组密度高于对照组。9例合并胰外病变或/和胰周结构直接侵犯。结论:AIP在CT上有特征性表现,动态增强扫描对其诊断具有重要意义,多数AIP病例可以通过CT检查确诊。Objective： To investigate the CT imaging findings of antoimmune pancreatitis （AIP）. Methods： The CT data of 11 patients with AIP were reviewed retrospectively. Plain CT scanning and dynamic contrast-enhanced scanning were per- formed in 11 patients. The location, shape of abnormal pancreas and the shape of boundary between normal and abnormal pancreas in segmental AIP were analyzed（in this text, the boundary is called ＂front-end＂ of abnormal pancreas, and the ab- normal pancreas between the boundary and the most bulky abnormal pancreas is called ＂forepart＂）. The CT attenuation value of the pancreatic parenchyma of AIP and normal pancreas in plain scanning, the arterial phase, portal vein phase and delayed phase were calculated. The mean CT attenuation value of the pancreatic parenehyma in patients with AlP was compared with that in patients with a normal pancreas （n=25）. Results： Four patients showed diffuse swelling of the pancreas and 7 patients showed segmental enlargement of pancreas. The tiny front-end and cone-shaped forepart was seen in 2 patients with segmen- tal AIP, and the flat front-end and trapezoid forepart in 1 patient with segmental AIP, and the areuate front-end and mimic bullet-point forepart in 3 patients with segmental AIP; the inimic bullet-point forepart at one side and the cone-shaped forepart at another side of abnormal pancreas in 1 patient with segmental AIP. Fusiform body of abnmTnal pancreas was seen in 3 patients of segmental AIP, irregular columnar body of abnormal pancreas with coarse edge in 3 patients with segmental AIP, and sausage body of abnormal pancreas in 5 patients. Abnormal pancreas showed homogeneous density, and the mean CT attenuation value of the abnormal pancreatic parenchyma was slightly lower than that of control group on plain scanning, significantly lower than that of control group in the arterial phase, slightly higher than that of control group in the portal vein phase. Conclusion： Abnormal pancreas of AIP may represent various shape,

关 键 词：胰腺炎:体层摄影术 螺旋计算机 

分 类 号：R576[医药卫生—消化系统] R814.42[医药卫生—内科学]