自身免疫性胰腺炎的MDCT特征和误诊分析  

Autoimmune pancreatitis：MDCT features and misdiagnosis analysis

作　　者：胡曙东[1,2] 谌业荣[1] 贾颖军[1] 倪恩珍[1] 宋琦[2] 林晓珠[2] 王亚非[1] 陈克敏[2] 

机构地区：[1]江苏大学附属人民医院放射科,江苏镇江212002 [2]上海交通大学医学院附属瑞金医院放射科

出　　处：《实用放射学杂志》2012年第10期1557-1560,共4页Journal of Practical Radiology

基　　金：基金项目：国家自然科学基金资助项目（81071281）;上海市科委生物医药重点项目（10JC1410900,10411953000）.

摘　　要：目的研究自身免疫性胰腺炎（autoimmunepancreatitis，AIP）的多层螺旋CT（MDCT）征象，以期提高对该病的认识和诊断正确率。方法收集2006--2011年行MDCT检查且病理最终确诊为AIP的13例患者，其中2例行MDCT血管成像。分析AIP的MDCT特征性表现，并与手术及病理结果进行比较。结果MDCT诊断为胰腺癌8例、囊腺癌3例、囊腺瘤2例。通过病理证实，13例均为AIP，全部误诊。胰腺弥漫肿大者7例，局限肿块型4例，混合型（胰腺弥漫性肿胀伴胰头局限性肿块）2例。9例病变周围见典型“胶囊样”包壳。动态增强扫描时，动脉期病变强化降低呈“雪花状”，后渐进性延迟强化。结论AIP具有特征性的MDCT影像表现，对于A1P的诊断和鉴别诊断具有重要意义，可避免不必要的手术。Objective To study the multi-detector computed tomography （MDCT） manifestations of autoimmune pancreatitis （AIP） and to improve the awareness and correct diagnosis rate of AIP. Methods MDCT characteristics of 13 cases who were diag- nosed with autoimmune pancreatitis from 2006 to 2011 were retrospectively reviewed. Among them, two patients were underwent MDCT angiography （CTA）. The MDCT features were compared with those of operative and pathological findings. Results 8 cases of pancreatic cancer, 3 cases of cystadenocarcinoma and 2 cases of pancreatic cancer were diagnosed by MDCT. All the lesions were diagnosed as autoimmune pancreatitis pathologically. All cases were misdiagnosis. All 13 patients showed enlargement of the pan- creas, with diffuse （n=7）, focal （n：4） or mixed （n：2） type. ＂Capsule-like＂ rim was present around the lesions in 9 cases. Mul- tiphasic dynamic MDCT analysis was performed, lesions demonstrated ＂snow-like＂ heterogeneously enhancement on the artery phase and gradually delayed increasing enhancement on the portal venous phase. Conclusion AIP have characteristic MDCT features, which play a very important role in the diagnosis of AIP and can help the patient to avoid unnecessary surgery.

关 键 词：胰腺 胰腺炎 自身免疫性 计算机体层成像 

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