胃肠道异位胰腺的CT表现与病理对照分析  

CT features of ectopic pancreas in gastrointestinal tract and its correlations with the pathology

作　　者：夏海泓[1] 尉从新[2] 刘本波[1] 初迎幸[1] XIA Haihong1,WEI Congxin2,LIU Benbo1,CHU Yingxing1(1 CT Room,the Affiliated Weihai Second Municipal Hospital of Qingdao University,Weihai 264200,China ; 2 Imaging Center,Qilu Hospital,Shandong University,Ji ＇nan 250011,Chin)

机构地区：[1]青岛大学附属威海市立第二医院CT室,山东威海264200 [2]山东大学齐鲁医院影像中心,山东济南250011

出　　处：《实用放射学杂志》2018年第3期382-385,共4页Journal of Practical Radiology

摘　　要：目的 探讨胃肠道异位胰腺的CT表现特点，并与病理对照分析。方法 回顾性分析20例经手术病理或内镜活检证实的胃肠道异位胰腺的临床资料，总结其特征表现。结果 胃肠道异位胰腺20例均为单发病灶，位于胃体小弯4例、胃窦大弯7例、胃窦小弯6例、胃角1例、十二指肠2例。异位胰腺长径0.8~3.5 cm，短径0.6~2.5 cm，长轴均与胃肠道壁平行。18例胃部异位胰腺中16例呈圆形或卵圆形，2例形态不规则且有浅分叶；2例十二指肠异位胰腺均呈卵圆形。12例边缘清楚，8例边缘模糊。CT平扫示异位胰腺密度多较均匀，其中18例向腔内生长，2例向腔外生长；2例可见囊变区。增强CT显示2例明显均匀强化，病理以胰腺腺泡为主要成分；14例中度强化，其强化程度接近于正常胰腺，病理显示由腺泡、胰岛、导管混合存在； 2例轻度强化，病理为分化成熟的黏液腺体伴胰腺导管；另有2例中心囊变区，囊变部分无强化。结论 胃肠道异位胰腺在长轴方向、腔内生长和强化方式等CT表现有其特点，不同的强化方式与其病理组成相关。Objective To explore CT features of ectopic pancreas in the gastrointestinal tract,and to compare and analyze with the pathological findings.Methods The clinical data of 20 cases with ectopic pancreas in gastrointestinal tract proved by surgery pathology or endoscopic biopsy were analyzed retrospectively,and the characteristics were summarized.Results Ectopic pancreas in gastrointestinal tract 20 single lesions, 4 cases at lesser curvature of gastric body,7 cases at greater curvature of gastric antrum, 6 cases at lesser curvature of gastric antrum, 1 case at gastric angle and 2 cases at duodenum.The longest diameter of ectopic pancreas was from 0.8 to 3.5 cm, while the shortest one was from 0.6 to 2.5 cm. The axis of the lesions was parallel to the wall of the gastrointestinal tract. For 18 ectopic pancreas in gastrointestinal tract, 16 were ovoid or round in shape, and the other 2 were slight lobulated.2 lesions in duodenum were ovoid in shape.12 lesions＇ margins were well-defined and ill-defined in other 8. Plain CT showed the ectopic pancreas with homogeneous density, 18 lesions with endoluminal growth and exophytic growth of other 2 cases. The cystic change was also found in 2 cases. Enhanced CT showed 2 lesions with significant homogeneous enhancement, mainly composed of pancreatic acini in pathology;14 with medium enhancement close to the normal pancreas, composed by pancreatic acini, islet and ducts, and 2 with slight enhancement, composed with mature differentiated mucous glands with ducts. Two lesions＇ center cystic change areas show no enhancement result.Conclusion The CT features,such as direction of its organic axis,endoluminal growth and enhancement patterns have its useful characteristics.Different enhanced patterns of ectopie pancreas in gastrointestinal tract are related with the pathologic change.

关 键 词：胃肠道 异位胰腺 计算机体层成像 

分 类 号：R573[医药卫生—消化系统] R814.42[医药卫生—内科学]