自身免疫性胰腺炎患者胰腺和胰外受累组织器官的影像分析  

CT and MRI characteristics of the pancreas and involved organs of patients with autoimmune pancreatitis

作　　者：刘发明 吉六舟[2] 鲁国卫[2] 

机构地区：[1]湖北省孝昌县第一人民医院CT室,432900 [2]湖北省孝感市中心医院CT/MRI室,432100

出　　处：《中华普外科手术学杂志（电子版）》2015年第5期86-88,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的分析自身免疫性胰腺炎(AIP)患者的胰腺与胰腺外受累组织器官的CT和MRI检查特点,为临床影像诊断AIP提供指导。方法回顾性分析2011年2月至2014年10月36例AIP患者的CT及MRI平扫检查资料进行分析,对两种检查方法的胰腺改变及胰腺外组织器官影像特点使用SPSS17.0软件分析,年龄、体重值(x珋±s)表示,采用两组独立样本的t检验;CT与MRI的影像学表现率采用卡方检验,等级计数资料比较采用非参数Z检验。P<0.05差异具有统计学意义。结果 36例AIP患者均以上腹部隐痛作为首发症状,有16例患者表现为黄疸(44.44%),12例患者表现为体重下降(33.33%),平均下降(6.4±2.8)kg。CT诊断胰腺肿大33例、MRI诊断胰腺肿大35例,肿大胰腺腺体呈"腊肠样"形状。CT诊断胆总管及肝内胆管扩张率(63.89%)高于MRI诊断胆总管及肝内胆管扩张率(38.89%)且差异具有统计学意义(P<0.05),MRI检出胰腺周围淋巴结肿大36.11%高于CT检出率16.67%,差异均具有统计学意义(χ2=4.741,P=0.029)。结论 AIP患者的胰腺病变的CT和MRI检查结果基本一致,对胰腺外器官受累的诊断上具有不一致性,所以对于AIP患者的综合诊断需要结合CT和MRI技术对患者的病情进行判断。Objective To analyze the characteristics of MRI and CT in the pancreas and involved organs of patients with autoimmnne pancreatitis （ AIP）, and to provide guidance for clinical imaging of AIP. Methods From February 2011 to October 2014, CT and MRI data of 36 patients with AIP were analyzed retrospectively by using the SPSS17.0 software. The 36 patients underwent both CT and MRI plain scan and changes of the pancreas and involved organs image features were comparatively analyzed. Measurement data were expressed as means ＋ standard deviation and examined by using two independent samples t test, including age, weight, while CT and MRI imaging features were examined by using the Chi-square test, and count data were compared with the non parameter Z test. P 〈 0.05 was considered as statistically significant. Results All of the 36 patients with AIP exhibited upper abdominal pain as the first symptom. Among them 16 （44.44%）patients had jaundice, and 12 （33.33%） patients had weight loss, （6.4 ±2.8） kg on average. Thirty-three patients with pancreatic enlargement were diagnosed by CT scan, whereas 35 patients with pancreatic enlargement by MRI diagnosis, with a ＂sausage like shape＂ . The CT diagnosis rate of common bile duct and intrahepatic bile duct dilatation （63.89%） was higher than that of MRI diagnosis （38.89%） （P 〈 0.05）. The detection rate of MRI for pancreatic lymph node swelling was 36. 11% , which was higher than 16.67% of CT scan （χ^2= 4. 741, P = 0.029）. Conclusions The CT and MRI results of AIP patients are similar in pancreatic diagnosis, but the diagnosis of extra pancreatic organ involvement is not consistent. Therefore, patients with AIP require a combination of CT and MRI scan for comprehensive diagnosis.

关 键 词：胰腺炎 自身免疫疾病 体层摄影术 螺旋计算机 磁共振成像 

分 类 号：R576[医药卫生—消化系统]