自身免疫性胰腺炎与小胰腺癌的CT、MRCP征象分析  

CT and MRCP findings of autoimmune pancreatitis and small pancreatic carcinoma

作　　者：丁玖乐[1] 邢伟[1] 左长京[2] 俞胜男[1] 邱建国[1] 生晶[3] 

机构地区：[1]苏州大学附属第三医院放射科,常州213003 [2]第二军医大学长海医院核医学科 [3]第二军医大学长海医院放射科

出　　处：《中华胰腺病杂志》2012年第2期79-82,共4页Chinese Journal of Pancreatology

摘　　要：目的分析自身免疫性胰腺炎（AIP）与小胰腺癌的CT、MRCP影像学征象的差异，提高对AIP的认识及诊断的准确率。方法回顾性分析符合2008年AIP亚洲诊断标准的24例AIP及病理证实的25例小胰腺癌（≤2cm）的影像学资料，从胰腺的形态改变、密度及强化方式、胰管及胰周、胰外表现等方面进行比较，采用Х^2检验或确切概率法行统计学处理。结果在AIP和小胰腺癌组间，肿块部位、远端胰腺萎缩、肿块持续强化、胰管“截断征”、“鞘膜征”及肾脏受累征象差异具有统计学意义（Х^2=9．010、10．506、15．288、8．688、6．292和4．966，P〈0．05），但是只有远端胰腺萎缩和肿块持续强化征象在局限性AIP与小胰腺癌组间差异具有统计学意义（P〈0．05）。结论弥漫性AIP的影像学改变具有特异性，与小胰腺癌容易鉴别诊断，但局灶性AIP与小胰腺癌鉴别诊断价值有限。Objective To increase the awareness of autoimmune pancreatitis （AIP） and correct diagnosis rate of AIP by investigating radiologic characteristic of AIP and small pancreatic cancers. Methods The clinical data and radiologic imaging of 24 AIP patients who met the Asia diagnostic criteria of AIP in 2008 and 25 cases of pathologically confirmed small pancreatic cancer were retrospectively reviewed. All imaging findings were reviewed, especially on the shape, enhancement patterns of mass, pancreatic ducts, peri- pancreatic and extra-pancreatic manifestations. Chi-square test and Fisher test were used for statistical analysis. Results The imaging signs, including location of masses, distal pancreatic atrophy, enhancing mass during portal phase, truncated duct sign of pancreatic duct, capsule-like rim and renal involvement, was significantly different between AIP and small pancreatic cancer （ Х^2 = 9. 010, 10. 506, 15. 488, 8. 688, 6. 292 and 4.966 respectively, P 〈 0. 05 ）. But only two signs, distal pancreatic atrophy and enhancing mass during arterial and portal phase, were statistically different between local AIP and small pancreatic cancer （P 〈 0.05 ）. Conclusions The typical imaging features of diffuse AIP is distinct and helpful for the differential diagnosis of AIP from small pancreatic carcinoma, but there is limited value in the differential diagnosis between local AIP and small pancreatic cancer.

关 键 词：自身免疫性胰腺炎 胰腺肿瘤 断层摄影 体层摄影术 X线计算机 磁共振 成像 

分 类 号：R735.9[医药卫生—肿瘤]