急性胰腺炎的并发症:胰周血管疾病的MRI表现  

Complications of Acute Pancreatitis:MRI Findings of Peripancreatic Vascular Disorders

作　　者：肖波[1,2] 蒋志琼[3] 张小明[1,2] 

机构地区：[1]川北医学院附属医院放射科,四川南充637000 [2]四川省医学影像重点实验室 [3]川北医学院附属医院老年科,四川南充637000

出　　处：《临床放射学杂志》2011年第11期1625-1628,共4页Journal of Clinical Radiology

摘　　要：目的探讨急性胰腺炎(AP)并发各类胰周血管疾病的MRI表现。资料与方法回顾性分析本院2009年6月至2010年9月期间122例AP患者资料,男73例,女49例,平均年龄(45±16)岁。所有病例均签署知情同意书。采用GE1.5TMR扫描:梯度回波T1加权,快速恢复快速自旋回波T2加权,单次激发快速自旋回波T2加权,MR胰胆管成像,动态增强扫描。观察:(1)动脉侵犯/动脉炎;(2)假性动脉瘤;(3)静脉炎、静脉血栓形成/静脉栓塞;(4)胰源性门静脉高压症/门静脉海绵样变。结果本组AP并发胰周血管病变的发生率为17.2%(21/122)。21例AP并发胰周血管病变患者中,动脉侵犯/动脉炎占16/21(脾动脉、肝总动脉、肠系膜上动脉、腹腔干受累率分别为16/16、13/16、12/16、7/16)。脾动脉假性动脉瘤占1/21。静脉炎占19/21(脾静脉、门静脉、肠系膜上静脉受累率分别为19/19、13/19、9/19),静脉血栓形成/静脉栓塞占2/21(1例脾静脉部分性栓塞,另1例门静脉、脾静脉、肠系膜上静脉广泛性栓塞)。胰源性门静脉高压症/门静脉海绵样变占2/21。结论 AP能并发多种胰周血管病变,每种血管病变都有较特异的MRI表现。Objective To discuss MRI features of acute pancreatitis（AP） coexisting with various peripancreatic vascular disorders.Materials and Methods 122 cases with AP were selected in this retrospective study at our hospital between June 2009 and September 2010.Patient informed consent was taken.MR imaging was performed with a 1.5T MR scanner included gradient echo T1 weighted imaging,fast recovery fast spin echo T2 weighted imaging,single shot fast spin echo T2 weighted imaging,MRCP and dynamic contrast enhanced MR imaging.A spectrum of vascular abnormalities included：（1） artery involvement/artery vasculitis;（2） pseudoaneurysm;（3） vein vasculitis,phlebothrombosis/vein occlusion;（4） pancreatic portal hypertension/portal sponge like changes were noted.Results In our study,the prevalence of AP coexisting with peripancreatic vascular disorders was 17.2%（21/122）.In 21 AP patients coexisting with peripancreatic vascular disorders,16/21 patients occurred artery involvement/artery vasculitis（the splenic artery,common hepatic artery,superior mesenteric artery and celiac trunk was respectively 16/16,13/16,12/16,and 7/16 involved）.The splenic pseudoaneurysm was determined in 1/21 on MRI.The vein vasculitis was determined in 19/21（the splenic vein,portal vein,and superior mesenteric vein was respectively 19/19,13/19,and 9/19 involved）.The phlebothrombosis/vein occlusion occurred in 2/21（one case was splenic vein partial occlusion,the other was widely vein occlusion in portal vein,splenic vein,and superior mesenteric vein）.2/21 patients were identified as pancreatic portal hypertension/portal sponge like changes.Conclusion AP may coexist with various peripancreatic vascular disorders.There are some specific MRI features for various peripancreatic vascular disorders.

关 键 词：急性胰腺炎 胰周血管 血管并发症 磁共振成像 

分 类 号：R576[医药卫生—消化系统]