自身免疫性胰腺炎的影像诊断  

Imaging diagnosis of autoimmune pancreatitis

作　　者：翟振艳[1] 黄文才[1] 陈志辉[1] 

机构地区：[1]解放军广州军区武汉总医院内分泌科,湖北武汉430070

出　　处：《临床军医杂志》2013年第3期272-274,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨自身免疫性胰腺炎(AIP)的动态增强CT及内镜逆行胰胆管造影(ERCP)影像学表现。方法收集并分析经组织病理学证实的7例AIP患者,治疗前的动态对比增强CT、ERCP检查资料及相关临床资料。结果 7例患者中,2例为弥漫型,5例为局限型AIP。治疗前增强CT检查显示受累胰腺早期强化程度弱于正常胰腺,呈延迟期轻中度强化;1例弥漫型AIP伴有肾脏低密度结节状病变。ERCP示各例AIP示主胰管弥漫或节段性狭窄,1例弥漫型和2例局限型AIP伴有胆管狭窄。类固醇激素治疗半年后CT复查显示,各例AIP胰腺炎症明显减轻,胰胆管狭窄改善。结论 AIP的影像表现具有一定特征性,类固醇治疗前影像学检查及治疗后随访有助于其明确诊断。Objective To elucidate the imaging features of autoimmune pancreatitis （AIP） in dynamic contrast-enhanced com- puterized tomography （CT） and endoscopic retrograde cholangiopancreatography （ERCP）. Methods Seven patients histopatholog- ically proved with AlP were collected, and their dynamic contrast-enhanced CT and ERCP examinations before treatment and rele- vant clinic data were reviewed retrospectively. Results In the patient group, there were two cases of diffuse-type AIP and five cases of localized AIP. In contrast-enhanced CT before treatment, the involved pancreatic parenchyma was usually poorly enhanced in early phase, and presented with mild to moderate enhancement in late phase. Low-density nodular lesions in kidney were revealed in one diffuse-type AIP. In ERCP, diffuse or segmental narrowing of main pancreatic duct was demonstrated in all AIP, and bile duct stricture was revealed in one diffuse-type and two localized AIP. The follow-up CT after steroid therapy revealed a remarkable relief of the pancreatic inflammation in all the patients, along with an upturn of pancreaticobiliary duct strictures. Conclusion AlP presents with some imaging features, and imaging examination before steroid therapy and during follow-up is helpful to its diagnosis.

关 键 词：自身免疫性胰腺炎 计算机体层摄影 内镜逆行胰胆管造影 诊断 

分 类 号：R816.5[医药卫生—放射医学]