胃部异位胰腺的CT增强表现及误诊分析  

Enhanced CT Features and Misdiagnosis Analysis of Heterotopic Pancreas in the Stomach

作　　者：靳晓媛 牛忠锋[1] JIN Xiaoyuan;NIU Zhongfeng(Department of Radiology,SIR RUN RUN SHAW Hospital School of Medicine,Zhejiang University,Hangzhou 310020,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院放射科,浙江杭州310020

出　　处：《中国医学影像学杂志》2021年第4期372-375,共4页Chinese Journal of Medical Imaging

摘　　要：目的分析胃部异位胰腺的CT增强表现及误诊原因,提高术前诊断准确率。资料与方法回顾性分析经病理证实的20例胃部异位胰腺患者的临床及CT增强资料,从病灶部位、大小、形态、边界、强化方式分析CT表现特征。分析增强扫描动脉期、静脉期病灶与正常胰腺CT值的相关性。结果20例胃部异位胰腺均为单发,其中14例位于胃体,5例位于胃窦,1例位于胃底;病灶位于黏膜下,长轴与局部胃壁一致,多呈卵圆形或扁平状,少数呈圆形。病灶长径(LD)为(1.98±0.59)cm,短径(SD)为(1.34±0.50)cm,LD/SD值为1.52±0.31。17例病灶向腔内生长,3例向腔内外生长。其中2例显示中央脐凹征,1例显示导管征。所有病灶平扫密度均匀,CT值为(44.4±4.7)Hu,动脉期、静脉期CT值分别为(81.3±14.9)Hu、(94.3±9.7)Hu,异位胰腺动脉期CT值与正常胰腺比较,差异有统计学意义(P<0.05),而平扫、静脉期CT值与正常胰腺比较,差异均无统计学意义(P>0.05)。异位胰腺动脉期、静脉期与正常胰腺同期相CT值呈显著正相关(r=0.736、0.873,P<0.05)。20例中,5例术前正确诊断为异位胰腺,13例误诊为间质瘤,2例诊断不明确。结论胃部异位胰腺CT表现多向腔内生长,呈卵圆形,LD/SD>1.4,增强扫描呈持续性强化,且静脉期病灶强化与正常胰腺类似,对异位胰腺的诊断更有价值,中央脐凹征和导管征是其特征性表现。Purpose To analyze the enhanced CT features and the reasons for misdiagnosis of heterotopic pancreas in the stomach,and to improve preoperative diagnostic accuracy.Materials and Methods The clinical data and enhanced CT features of 20 patients with pathologically confirmed gastric heterotopic pancreas were retrospectively analyzed.The location,size,shape and contrast-enhancement CT patterns of lesions were analyzed.Results Twenty cases were all single lesion,including 14 lesions were located in the stomach body,5 lesions in the antrum,1 lesion in the fundus.The lesions were located under the stomach mucosa,they were oval or flat like protrusion with broad base mostly,a few were round.The mean long dimension(LD)of lesion was(1.98±0.59)cm,the mean short dimension(SD)of lesion was(1.34±0.50)cm,the mean LD/SD value was(1.52±0.31)cm.For the growth pattern of 20 lesions,there were 17 lesions with intraluminal growth and 3 lesions with intra-extraluminal growth.Two lesions showed typical small central umbilication and one lesion showed low density ductal structure.All 20 lesions showed homogeneous density on the plain phase,and the mean CT value of all lesions was(44.4±4.7)Hu.On the arterial and venous phase,the average CT values were(81.3±14.9)Hu and(94.3±9.7)Hu,respectively.There was a significant difference in the arterial phase CT value between gastric heterotopic pancreas and the normal pancreas(P<0.05).There were no significant differences in the plain and vein phase CT values between gastric heterotopic pancreas and the normal pancreas(P>0.05).There were significant correlations in CT values between heterotopic pancreas and the normal pancreas on the arterial and venous phase,and the correlation coefficient was 0.736 and 0.873,respectively(P<0.05).A total of 5 out of the 20 patients were correctly diagnosed as heterotopic pancreas in the stomach preoperatively,and 13 cases were misdiagnosed as stromal tumor other lesions,and 2 cases were in indefinite diagnosis.Conclusion CT findings of heterotopic pancreas

关 键 词：异位胰腺 胃 体层摄影术 X线计算机 病理学 外科 误诊 

分 类 号：R445.3[医药卫生—影像医学与核医学] R322[医药卫生—诊断学]