CAJ | 학술논문

目的探讨自身免疫性胰腺炎(AIP)的影像特征及其在AIP诊断中的价值.方法回顾性分析13例AIP患者的影像和临床资料.结果 11例AIP表现为胰腺弥漫性肿大,2例胰头局限性肿大.CT平扫病变密度均均匀.4例在MR T1WI上信号降低、T2WI上信号轻度升高,增强后动脉期病变轻度强化,门脉期及延迟期进一步强化.9例胰腺周围有包膜样结构.横轴位图像上肝内外胆管扩张、胆总管胰腺段狭窄或闭塞10例,胰管未显影11例.6例行MRCP者有4例显示胆总管胰腺段较大范围狭窄或闭塞,胰管节段性狭窄.7例ERCP显示胰管弥漫性、不规则狭窄.胰周静脉受累8例,肾脏多发低密度灶6例,腹膜后纤维化2例,肝门部胆管狭窄1例,肺间质病变1例,强直性脊柱炎1例.结论 AIP的影像学征象具有一定特征性,影像检查在AIP诊断中起重要作用.识别胰腺外脏器受累对正确诊断AIP有帮助.
목적 탐토자신면역성이선염(AIP)적영상특정급기재AIP진단중적개치.방법 회고성분석13례AIP환자적영상화림상자료.결과 11례AIP표현위이선미만성종대,2례이두국한성종대.CT평소병변밀도균균균.4례재MR T1WI상신호강저、T2WI상신호경도승고,증강후동맥기병변경도강화,문맥기급연지기진일보강화.9례이선주위유포막양결구.횡축위도상상간내외담관확장、담총관이선단협착혹폐새10례,이관미현영11례.6례행MRCP자유4례현시담총관이선단교대범위협착혹폐새,이관절단성협착.7례ERCP현시이관미만성、불규칙협착.이주정맥수루8례,신장다발저밀도조6례,복막후섬유화2례,간문부담관협착1례,폐간질병변1례,강직성척주염1례.결론 AIP적영상학정상구유일정특정성,영상검사재AIP진단중기중요작용.식별이선외장기수루대정학진단AIP유방조.
Objective To investigate the imaging characteristics of autoimmune pancreatitis (AIP)and its diagnostic value.Methods Imaging examinations and clinical data of 13 patients with AIP were reviewed retrospectively.Results All patients had enlargement of pancreas either diffusely ( n =11 ) or focally in pancreatic head ( n =2 ).The swollen pancreas was of homogeneous density on CT scan ( n =13 ),hypointense on T1-weighted images and mildly hyperintense on T2-weighted images in 4 patients.It was demonstrated as mild enhancement on artery phase of dynamic imaging and progressive enhancement on portal and delayed phase images.Capsule-like enhanced rim was presented around the pancreas in 9 patients.Stricture or obliteration of the common bile duct located in pancreatic head was found in 10 patients accompanied by intrahepatic bile duct dilation.Pancreatic duct was invisible on axial images in 11 cases.Among the 6 patients underwent MRCP,it was showed diffuse and irregular narrowing of the main pancreatic duct and stricture of common bile duct located in pancreatic head in 4 cases.ERCP showed diffuse and irregular narrowing of the main pancreatic duct in 7 cases.Extra-pancreatic lesion included veins around pancreas involvement in 8 cases;multiple low density renal lesions in 6 cases; retroperitoneal fibrosis in 2 cases; stricture of hilar duct,interstitial lung disease and ankylosing spondylitis in 1 case,respectively.Conclusions AIP shows some characteristic imaging features,and imaging examinations play an important role in the diagnosis of AIP.Recognition of extra-pancreatic lesions aids in the correct diagnosis of AIP.