胃囊性异位胰腺的影像学特点与误诊分析  

Gastric cystic heterotopic pancreas:imaging features and analysis of misdiagnosis

作　　者：韩懿静 梁盼[1] 李莉明[1] 柴亚如 高剑波[1] 杨志浩[1] HAN Yijing;LIANG Pan;LI Liming;CHAI Yaru;GAO Jianbo;YANG Zhihao(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院放射科,河南郑州450052

出　　处：《实用放射学杂志》2022年第3期408-411,458,共5页Journal of Practical Radiology

基　　金：国家自然基金面上项目(81971615).

摘　　要：目的探讨胃囊性异位胰腺(CHP)的影像学特点,提高对该病的认识.方法回顾分析6例经病理证实的胃CHP患者的影像及临床资料.5例行CT检查,1例行MRI检查,分析CHP的影像学特点.结果所有病灶均为单发,胃体部2例,胃窦部4例,长径(LD)/短径(SD)>1.4共4例,边界清5例,边界欠清1例.5例行CT检查的患者中,2例呈囊实性密度,3例呈囊性低密度,囊实性病灶内的实性分隔及结节与正常胰腺的影像表现一致;囊壁稍厚,常不规则,整体或局部呈持续性或渐进性明显或中度强化,囊内低密度区无强化或仅轻微强化.行MRI检查的1例病灶,囊内信号均匀,T_(1) WI呈低信号,T_(2) WI呈高信号,扩散加权成像(DWI)病变扩散受限呈高信号,囊壁局部呈轻度线样强化.结论当胃囊性病灶的实性成分表现为正常胰腺组织影像学特点时,首先考虑CHP,当无典型表现时需要与胃壁其他囊性病变进行鉴别.Objective To investigate the imaging features of gastric cystic heterotopic pancreas(CHP),to improve the understanding of this disease.Methods The imaging and clinical data of 6 patients with gastric CHP confirmed by pathology were analyzed retrospectively.5 patients underwent CT examination and 1 underwent MRI examination.The imaging characteristics of CHP were analyzed.Results All lesions were solitary in the body(n=2)or antrum(n=4)of the stomach,with a long diameter(LD)/short diameter(SD)ratio>1.4 in 4 cases.The lesion border was clear in 5 lesions and unclear in only one.Among the 5 patients who underwent CT examination,2 had solid-cystic lesions,and 3 had cystic ones.The CT manifestations of solid compartments and nodules in the solid-cystic lesions were similar to the normal pancreas;meanwhile the cyst wall was slightly thicker and often irregular.The whole or part of the cyst wall showed persistently or progressively obvious or moderate enhancement.The low-density area in the cyst had no enhancement or only slight enhancement.The signal of the cystic area in 1 lesion on MRI images was uniform,with low signal on T_(1) WI,high signal on T_(2) WI and diffusion weighted imaging(DWI)showed high signal of limited diffusion,and the local cyst wall showed mild linear enhancement.Conclusion When the imaging characteristics of solid components of gastric cystic lesions are similar to the normal pancreatic tissue,CHP should be considered firstly.Otherwise it should be differentiated from other cystic lesions of the gastric wall.

关 键 词：胃 异位胰腺 囊性 计算机体层成像 磁共振成像 

分 类 号：R573[医药卫生—消化系统] R814.42[医药卫生—内科学] R445.2[医药卫生—临床医学]