胰腺钩突部局灶性回声减低:正常变异或是肿瘤  

Focal Hypoechoic Region in the Uncinate Process of Pancreas:Normal Variation or Tumor

作　　者：陈香梅[1,2] 崔立刚[1] 王金锐[1] 贾建文[1] 陈文[1] 

机构地区：[1]北京大学第三医院超声诊断科,北京市100191 [2]北京大学深圳医院超声诊断科

出　　处：《中国超声医学杂志》2013年第3期273-276,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的总结胰腺钩突部局灶性低回声区的声像图特点和分布规律,为该现象与同部位肿瘤的鉴别诊断提供依据。方法分析10例常规腹部超声检查发现胰腺钩突部回声减低患者的声像图资料,其中3例患者进行了胰腺超声造影检查,2例患者进行了MRI检查,其余5例患者在1个月后进行了超声随访。结果 10例患者均在胰腺钩突部显示三角形的低回声区,边界清晰锐利,范围约(2.5～3.7)cm×(0.7～1.3)cm×(2.9～3.8)cm(左右径×前后径×上下径),其余胰腺实质呈均匀高回声。3例超声造影患者钩突部低回声区增强模式与其余胰腺组织相同,未见异常增强或廓清;2例MRI检查患者胰腺均未发现明显占位性病变。其余5例患者1个月后随访低回声区范围未见明显变化。10例患者均排除占位可能,考虑为局灶性脂肪沉积缺失所致。结论超声检查发现胰腺钩突部低回声区而不伴钩突形态改变及其他占位效应时,需要考虑局灶性胰腺脂肪沉积缺失可能。超声造影检查、MRI或超声随访可明确诊断。Objective To summary the distributional and ultrasonographic characteristics of the hypoechoic re- gion in the uncinate process of pancreas, and to distinguish it from tumors in this site. Methods Contrast enhanced ultrasound（CEUS）, Magnatic Resonance Imaging （MRI） and short term follow-up abdominal ultrasound were applied to analyze 10 patients having hypoechoie regions in the uncinate process of pancreas. Three patients received pancreas CEUS, 2 received MRI, the other 5 patients received ultrasonic follow up one month later. Results Triangular hypo- echoic regions were found in the uncinate process of pancreas in all of the 10 patients, with distinct margins. The sizes of the hypoechoic regions were （2.5 - 3.7 ）cm × （0.7 - 1.3 ）cm × （2.9- 3.8）cm（ transverse × anteroposterior × axial diameters）. The CEUS enhancement patterns of the hypoechoic region of the uneinate process and the rest of the pan- creas were the same, without abnormal enhancement or clearance in the 3 patients received CEUS; 2 patients with MRI did not showed neoplasma in the pancreas; and the other 5 patients with ultrasonic follow-up one month later showed no changes in their hypoechoic areas. All of the 10 patients were excluded from the possibilities of pancreatic tumors, and were considered to be absence of fat deposition. Conclusions Absence of fat deposition should he consid ered when ultrasound examination of the uncinate process of the pancreas finds hypoechoic areas without morphologic change of the pancreas, dilated pancreatic duct, infiltration or metastasis of tissues nearby. CEUS, MRI or ultrasonic follow up could be applied to confirm the diagnosis when needed.

关 键 词：胰腺 钩突 回声减低 脂肪沉积 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.9[医药卫生—诊断学]