自身免疫性胰腺炎的CT及MRI特点和诊断价值  

CT and MRI features and diagnostic value of autoimmune pancreatitis

作　　者：张建英[1] 张福洲[1] 胡凌云[2] 蒋瑾 何孔明[1] ZHANG Jianying;ZHANG Fuzhou;HU Lingyun;JIANG Jin;HE Kongming(Medical Imaging Center,The Second Clinical Medical College,North Sichuan Medical College,Nanchong Central Hospital,Nanchong 637000,Sichuan,China;Departmenf of Orthopedics,The Second Clinical Medical college,North Sichuan Medical College,Nanchong Central Hospital,Nanchong 637000,Sichuan,China;Department of Radiology,Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital,Chengdu 610000,China)

机构地区：[1]川北医学院第二临床医学院.南充市中心医院医学影像中心,四川南充637000 [2]川北医学院第二临床医学院.南充市中心医院骨科,四川南充637000 [3]四川省医学科学院.四川省人民医院放射科,四川成都610000

出　　处：《西部医学》2018年第11期1658-1661,1671,共5页Medical Journal of West China

基　　金：国家自然科学基金(81100929)

摘　　要：目的探讨自身免疫性胰腺炎(AIP)的CT、MRI影像学表现特征及其诊断价值。方法回顾性分析南充市中心医院13例经病理及临床治疗后证实的AIP的CT及MRI特征。13例患者均行CT平扫及增强扫描,其中10例行磁共振成像(MRI)及薄层磁共振胰胆管造影。结果 CT检查发现13例患者中,8例胰腺弥漫性肿大,5例局限性肿胀,呈团块样肿改变;CT平扫为均匀一致的略低密度,有9例出现明显延迟强化,8例患者胰周显示模糊,7例出现鞘膜征。10例MRI检查者在T1WI呈等低信号,T2WI呈略高信号,薄层MRCP显示3例胆总管呈鼠尾状狭窄,且3例均被误诊为胆总管胰腺段占位;5例胰管呈节段性狭窄或轻度扩张,3例患者与周围血管分界不清。结论自身免疫性胰腺炎的CT与MRI影像学表现具有一定的特征性,根据影像学表现可对多数患者作出正确的诊断。Objective To investigate the CT and MRI features of autoimmune pancreatitis(AIP)and its clinical diagnostic value.Methods The CT and MRI imaging features of 13 cases of AIP confirmed by pathology and clinical treatment were analyzed retrospectively.CT scan and enhanced scan were performed in 13 patients,of whom 10 underwent magnetic resonance imaging(MRI)and thin layer magnetic resonance cholangiopancreatography.Results In the 13 cases of patients under CT examination,8 patients had diffuse enlargement of the pancreas,5 patients had localized swelling of the pancreas,and was swollen-like changes.The CT scan was homogeneous,with a slightly lower density,and 9 patients showed marked delayed enhancement.In 8 patients,the pancreas showed blurring and 7 had the appearance of the tunica vaginalis sign.T1WI of MRI examination of 10 cases showed low signal,T2WI showed slightly high signal.Thin MRCP showed 3 cases of common bile duct in rat caudate stenosis,3 cases were misdiagnosed as common bile duct and pancreatic segment occupying;5 cases of pancreatic duct showed segmental stenosis or mild dilatation,3 cases of patients with peripheral vascular boundary is not clear.Conclusion The imaging features of autoimmune pancreatitis have some characteristics,and correct diagnosis can be made for most patients according to the imaging findings.

关 键 词：自身免疫性胰腺炎 体层摄影术 X线计算机 磁共振成像 

分 类 号：R814[医药卫生—影像医学与核医学] R576[医药卫生—放射医学]