CAJ | 학술논문

目的：分析异位胰腺的 CT 表现及其与病理的联系。方法回顾性分析19例经手术证实的异位胰腺的 CT 资料,其中14例行 CT 增强检查,分析 CT 表现的特征。结果19例异位胰腺均为单发病灶,直径0.8~4.7 cm,平均(2.2±0.6)cm。CT 平扫示病灶密度较均匀,其中位于胃部7例,十二指肠8例,空肠2例,回肠1例,贲门淋巴结旁1例。5例病灶边界模糊,周围呈渗出性改变,类似急性胰腺炎,2例显示中央脐凹征。病理证实异位于黏膜下14例,肌层3例,浆膜1例,1例位于腹腔内。动态增强扫描9例早期呈明显强化,类似胰腺强化和强化后的衰减,病理组成以胰腺腺泡组织为主,4例强化程度低于正常胰腺,病理以胰腺导管及少量胰腺腺泡组成,1例强化不明显,CT 表现类似平滑肌瘤,病理以胰腺导管及增生平滑肌为主。结论异位胰腺多呈黏膜下病变特征,不同的强化方式与其病理组成密切相关。
목적：분석이위이선적 CT 표현급기여병리적련계。방법회고성분석19례경수술증실적이위이선적 CT 자료,기중14례행 CT 증강검사,분석 CT 표현적특정。결과19례이위이선균위단발병조,직경0.8~4.7 cm,평균(2.2±0.6)cm。CT 평소시병조밀도교균균,기중위우위부7례,십이지장8례,공장2례,회장1례,분문림파결방1례。5례병조변계모호,주위정삼출성개변,유사급성이선염,2례현시중앙제요정。병리증실이위우점막하14례,기층3례,장막1례,1례위우복강내。동태증강소묘9례조기정명현강화,유사이선강화화강화후적쇠감,병리조성이이선선포조직위주,4례강화정도저우정상이선,병리이이선도관급소량이선선포조성,1례강화불명현,CT 표현유사평활기류,병리이이선도관급증생평활기위주。결론이위이선다정점막하병변특정,불동적강화방식여기병리조성밀절상관。
Objective To analyze the CT findings of heterotopic pancreas and the correlation with pathologic changes.Methods CT findings in 1 9 patients with heterotopic pancreas proven by surgery were reviewed retrospectively,14 of whom were scanned with enhanced CT.The correlation of CT findings and pathologic results were also analyzed.Results All patients had a single lesion with sized range from 0.8 to 4.7 cm and mean diameter of (2.2±0.6)cm.All lesions with homogeneous density were showed on plain scans including 7 lesions in stomach,8 in duodenum,2 in jejunum,1 in ileum and 1 beside the cardiac lymph nodes.The border of the lesions in 5 was unclear with exudative changes,mimicking acute pancreatitis.A sign of central umbilical concave was found in 2.Pathological results confirmed 14 lesions in submucosa,3 in muscular layer,1 in serosal layer and 1 in abdominal cavity.Hetero-topic pancreas presented early obvious enhancement in 9,mimicking normal pancreas,which was composed chiefly of pancreatic aci-ni.The enhanced degree of 4 lesions was lower than normal pancreas,which were composed of pancreas ductal epithelium and few pancreatic acini.No significantly enhancement was seen in 1,mimicing liomyoma,which was composed chiefly of pancreas ductal epithelium and smooth muscle hyperplasia.Conclusion Heterotopic pancreas in most cases presents characteristic submucosal disea-ses-like pattern,and different enhanced patterns of heterotopic pancreas are related with the pathologic changes.