Ⅰ型自身免疫性胰腺炎的CT及MRI表现  

CT and MRI Features of Type Ⅰ Autoimmune Pancreatitis

作　　者：李玲[1,2] 陈维翠 刘波 胡少为 刘岘 LI Ling;CHEN Weicui;LIU Bo;HU Shaowei;LIU Xian(不详;Department of Radiology,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广州中医药大学第二附属医院影像科(广东省中医院),广东广州510120 [3]广州中医药大学第二附属医院病理科(广东省中医院),广东广州510120

出　　处：《中国医学影像学杂志》2021年第1期65-68,72,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨Ⅰ型自身免疫性胰腺炎(Ⅰ-AIP)的CT及MRI表现。资料与方法回顾性分析16例经病理证实的I-AIP的临床资料、CT及MRI表现。结果 16例I-AIP中,14例IgG4水平升高;胰腺弥漫型受累9例,呈"腊肠状"改变,其中6例可见"胶囊征";局灶型受累7例。CT平扫呈均匀等或低密度,MRI平扫T1WI呈低信号,T2WI呈稍高信号,扩散加权成像呈轻度扩散受限,病灶内未见坏死、囊变、钙化征象,动态增强扫描呈延迟强化。磁共振胰胆管造影显示主胰管弥漫性扩张6例,局限性扩张3例,伴肝内外胆管扩张8例。7例出现腹腔内淋巴结肿大,1例合并腹膜后纤维化。结论Ⅰ-AIP的影像表现多样,呈"腊肠状"改变、"胶囊征"、胰胆管受累及胰外器官受累等特征。结合血清学IgG4升高有助于早期鉴别诊断。Purpose To investigate the CT and MRI features of type I autoimmune pancreatitis(I-AIP).Materials and Methods The clinical,CT and MRI data of 16 patients with pathologically conformed I-AIP were retrospectively reviewed.Results For 16 patients,14 showed increased IgG4;9 showed diffuse disease which expressed as a“sausage-like”change,6 showed“capsule-like rim”,7 showed focal lesions.The lesion demonstrated hypoattenuating on CT plain scan,mildly hyper-intensity on T2WI,and hypo-intensity on T1WI,with mildly restricted diffusion on DWI.No necrosis,cystic portion or calcification was observed in lesions.The contrast agent injection resulted in a gradual and persistent enhancement of lesion over time.Magnetic resonance cholangiopancreatography showed diffuse expansion of the main pancreatic duct in 6 cases,and localized expansion of the main pancreatic duct in 3 cases,with intrahepatic and extrahepatic bile duct dilatation in 8 cases.7 cases of intra-abdominal lymphadenopathy and 1 case of retroperitoneal fibrosis were observed.Conclusion The imaging characteristics of I-AIP are diverse,including“sausage like”change,“capsule sign”,pancreaticobiliary and extra-pancreatic organ involvement,combined with increased serological IgG4 level may contribute to early differential diagnosis.

关 键 词：胰腺炎 自身免疫疾病 体层摄影术 X线计算机 磁共振成像 病理学 外科 免疫球蛋白G 

分 类 号：R576[医药卫生—消化系统] R445.2[医药卫生—内科学]