自身免疫性胰腺炎胰外病变的影像表现  

Autoimmune pancreatitis:extrapancreatic imaging findings

作　　者：倪瑞军[1] 王伯胤[1] 许顺良[2] 阮翎翔[2] 

机构地区：[1]浙江大学绍兴医院放射科,浙江312000 [2]浙江大学医学院附属第一医院放射科,杭州310003

出　　处：《放射学实践》2012年第2期190-194,共5页Radiologic Practice

摘　　要：目的:分析自身免疫性胰腺炎(AIP)胰外病变的影像特点,提高对AIP认识和诊断水平。方法:搜集17例AIP患者的CT和/或MR资料,分析总结胰周假包膜形成,血管受累,胆道扩张,腹膜后纤维化及远处器官侵犯等胰外病变的影像学表现。结果:17例AIP中10例伴胰周假包膜形成,假包膜的部位、形态呈多样性;5例伴脾动脉和/或脾静脉受累;5例伴胆管扩张,其中1例伴节段性胆管壁增厚、管腔狭窄;2例伴肾侵犯,1例伴肠系膜侵犯,肾内和肠系膜病变均呈结节状较高软组织密度,质地均匀,进行性均匀强化;1例伴腹膜后纤维化,纤维组织质地均匀度、强化特点与肾内及肠系膜病变相同。结论:胰周假包膜对AIP诊断有肯定意义,其它胰外病变亦具有一定特征性。掌握AIP胰外病变的影像特征有利于该病的诊断与鉴别诊断,减少误诊。Objective：To investigate the CT findings of extrapancreatic lesion of autoimmune pancreatitis（AIP） aiming to improve the diagnosis of AIP.Methods：The CT（and/or MRI） data of 17 patients with AIP were retrospectively reviewed.The various extrapancreatic imaging findings were analyzed,including the pseudocapsules,the vascular involvement around the pancreas,the dilatation of bile duct,the retroperitoneal fibrosis and involvement of distant organs.Results：Abnormal peripheral pseudocapsules were seen in 10 patients with AIP,and the sites and appearance of pseudocapsules varied.Splenic artery（and/or vein） was involved in 5 patients with AIP,there was concentric narrowing of blood vessel without displacement.Dilated bile duct was seen in 5 patients with AIP,one of which showed wall thickening and concentric narrowing.Renal involvement was present in 2 patients with AIP while mesentery involvement in 1 patient,the lesions in the kidney and mesentery appeared as nodular,homogeneous and progressing enhancement.Retroperitoneal fibrosis was seen in 1 patient,the fibrosis located at peripancreatic region,adjacent to aorta abdominals and surrounding the right common iliac artery,this fibrosis had the same characteristics as the lesions in the kidney and mesentery.Conclusion：The extrapancreatic imaging findings can mimic those of other diseases and play an important role in diagnosing AIP.Therefore,it is important for radiologists to understand extrapancreatic imaging findings of autoimmune pancreatitis for making accurate and timely diagnoses.

关 键 词：自身免疫疾病 胰腺炎 体层摄影术 X线计算机 磁共振成像 

分 类 号：R576.9[医药卫生—消化系统] R445.2[医药卫生—内科学]