放射学实践
放射學實踐
방사학실천
RADIOLOGIC PRACTICE
2014年
9期
1059-1063
,共5页
胰腺炎%自身免疫性胰腺炎%体层摄影术,X 线计算机%磁共振成像
胰腺炎%自身免疫性胰腺炎%體層攝影術,X 線計算機%磁共振成像
이선염%자신면역성이선염%체층섭영술,X 선계산궤%자공진성상
Pancreatitis%Autoimmune pancreatitis%Tomography,X-ray computed%Magnetic resonance imaging
_目的：探讨 CT 及 MRI 对自身免疫性胰腺炎（AIP）的诊断价值。方法：回顾性分析经实验室检查、穿刺活检、手术或临床激素治疗有效确诊的28例 AIP 患者的临床及影像学资料。21例行 CT 检查，其中17例行 CT 增强扫描；18例行 MRI 检查，其中11例行 MRI 增强扫描，12例行 MRCP 扫描；15例同时行 CT 及 MRI 扫描。结果：CT 与 MRI 可清楚显示胰腺实质及胰腺外脏器的形态、密度或信号改变。胰腺实质表现：胰腺弥漫性增大呈＂腊肠＂样改变，边缘呈＂香蕉皮＂样改变；局限性病变病灶呈＂假肿瘤＂样改变，增强扫描延迟期与正常胰腺实质密度、信号一致。胰腺外脏器表现：胆系改变表现为胆总管及肝内胆管扩张，管壁增厚，增强扫描呈明显强化；肾脏改变表现为 CT 增强扫描动脉期呈斑片状低密度，MRI 呈稍长 T1、稍长 T2信号，延迟期病灶与周围肾实质密度、信号一致；肺内改变表现为肺门区软组织肿块影。结论：自身免疫性胰腺炎 CT 及 MR 表现具有一定特征性，对于该病的诊断及治疗前后疗效的评估具有重要价值。
_目的：探討 CT 及 MRI 對自身免疫性胰腺炎（AIP）的診斷價值。方法：迴顧性分析經實驗室檢查、穿刺活檢、手術或臨床激素治療有效確診的28例 AIP 患者的臨床及影像學資料。21例行 CT 檢查，其中17例行 CT 增彊掃描；18例行 MRI 檢查，其中11例行 MRI 增彊掃描，12例行 MRCP 掃描；15例同時行 CT 及 MRI 掃描。結果：CT 與 MRI 可清楚顯示胰腺實質及胰腺外髒器的形態、密度或信號改變。胰腺實質錶現：胰腺瀰漫性增大呈＂臘腸＂樣改變，邊緣呈＂香蕉皮＂樣改變；跼限性病變病竈呈＂假腫瘤＂樣改變，增彊掃描延遲期與正常胰腺實質密度、信號一緻。胰腺外髒器錶現：膽繫改變錶現為膽總管及肝內膽管擴張，管壁增厚，增彊掃描呈明顯彊化；腎髒改變錶現為 CT 增彊掃描動脈期呈斑片狀低密度，MRI 呈稍長 T1、稍長 T2信號，延遲期病竈與週圍腎實質密度、信號一緻；肺內改變錶現為肺門區軟組織腫塊影。結論：自身免疫性胰腺炎 CT 及 MR 錶現具有一定特徵性，對于該病的診斷及治療前後療效的評估具有重要價值。
_목적：탐토 CT 급 MRI 대자신면역성이선염（AIP）적진단개치。방법：회고성분석경실험실검사、천자활검、수술혹림상격소치료유효학진적28례 AIP 환자적림상급영상학자료。21례행 CT 검사，기중17례행 CT 증강소묘；18례행 MRI 검사，기중11례행 MRI 증강소묘，12례행 MRCP 소묘；15례동시행 CT 급 MRI 소묘。결과：CT 여 MRI 가청초현시이선실질급이선외장기적형태、밀도혹신호개변。이선실질표현：이선미만성증대정＂석장＂양개변，변연정＂향초피＂양개변；국한성병변병조정＂가종류＂양개변，증강소묘연지기여정상이선실질밀도、신호일치。이선외장기표현：담계개변표현위담총관급간내담관확장，관벽증후，증강소묘정명현강화；신장개변표현위 CT 증강소묘동맥기정반편상저밀도，MRI 정초장 T1、초장 T2신호，연지기병조여주위신실질밀도、신호일치；폐내개변표현위폐문구연조직종괴영。결론：자신면역성이선염 CT 급 MR 표현구유일정특정성，대우해병적진단급치료전후료효적평고구유중요개치。
To investigate the values of CT and MRI fingdings in autoimmune pancreatitis (AIP)and to re-view related literature.Methods:We retrospectively studied 28 patients with autoimmune pancreatitis proved by laboratory examination,biopsy,surgery or effective clinical hormone therapy.21 cases underwent CT scan including 17 enhanced scan.18 patients received MR scan including 11 enhanced scan.12 cases underwent MRCP and 15 patients underwent both CT and MR examinations.Results:CT and MR main findings in AIP included a diffusely enlarged pancreas or a focal mass with delayed enhancement on dynamic scanning.A high-density sausage-shaped pancreas with the edge like banana skin on diffusion weighted imaging was a typical sign in AIP.A focal mass that might be mistaken for a pancreatic malignancy, named false tumor sign,was an additional characteristic feature.Findings when involving extrapancreatic organs included dilatation of intrahepatic and extrahepatic bile ducts,bile duct wall thickening and significant enhancement.When involving the kidney,a focal low density in arterial phase was seen on CT.MRI showed relatively long T1 and T2 signal.In delayed phase of MR the lesion showed similar density and signal of surrounding renal parenchyma.Hilar mass was found when lung got involved.Conclusion:CT and MR can clearly show the changes in density and signal of pancreatic parenchyma and extrapancreatic organ involvements in autoimmune pancreatitis.CT and MR findings in AIP have some specific characteris-tics,which can be valuable signs to differentiate with other similar conditions,and play an important role in diagnosis and e-valuation of therapeutic effects.
