CAJ | 학술논문

目的对比分析自身免疫性胰腺炎(AIP)患者与胰腺癌(PC)患者的影像学资料,提高AIP与PC在影像学方面的鉴别诊断能力.方法选取术后病理符合AIP亚洲标准的患者36例及符合PC病理诊断标准的患者95例,总结AIP与PC的影像学特点及差异.结果增强CT发现胰头增大或肿块、胰周淋巴结肿大、胰胆管和胆总管扩张及截断、血管和脏器受累方面AIP明显少于PC(11/27比28/40、2/27比17/40、13/27比32/40、1/27比10/40、8/27比26/40、2/27比15/40、0/27比15/40、0/27比10/40),差异有统计学意义(P＜0.05),在胰腺普遍增大、钙化或胰石、假包膜影或胰周脂肪间隙模糊方面AIP明显多于PC (4/27比0/40、7/27比0/40、10/27比6/40),差异有统计学意义(P＜0.05).三维彩超发现在胰胆管扩张直径和胆总管扩张方面AIP明显少于PC [(0.421 ±0.270)cm比(0.594±0.270) cm、1/18比16/26],差异有统计学意义(P＜0.05).磁共振胰胆管成像发现胆总管扩张及胰胆管截断方面AIP明显少于PC(7/13比16/18、1/13比10/18),差异有统计学意义(P＜0.05).结论 AIP作为一种特殊类型的慢性胰腺炎,在影像学方面可与PC进行鉴别诊断.
목적 대비분석자신면역성이선염(AIP)환자여이선암(PC)환자적영상학자료,제고AIP여PC재영상학방면적감별진단능력.방법 선취술후병리부합AIP아주표준적환자36례급부합PC병리진단표준적환자95례,총결AIP여PC적영상학특점급차이.결과 증강CT발현이두증대혹종괴、이주림파결종대、이담관화담총관확장급절단、혈관화장기수루방면AIP명현소우PC(11/27비28/40、2/27비17/40、13/27비32/40、1/27비10/40、8/27비26/40、2/27비15/40、0/27비15/40、0/27비10/40),차이유통계학의의(P＜0.05),재이선보편증대、개화혹이석、가포막영혹이주지방간극모호방면AIP명현다우PC (4/27비0/40、7/27비0/40、10/27비6/40),차이유통계학의의(P＜0.05).삼유채초발현재이담관확장직경화담총관확장방면AIP명현소우PC [(0.421 ±0.270)cm비(0.594±0.270) cm、1/18비16/26],차이유통계학의의(P＜0.05).자공진이담관성상발현담총관확장급이담관절단방면AIP명현소우PC(7/13비16/18、1/13비10/18),차이유통계학의의(P＜0.05).결론 AIP작위일충특수류형적만성이선염,재영상학방면가여PC진행감별진단.
Objective To improve the differential diagnosis between autoimmune pancreatitis (AIP) and pancreatic cancer (PC) by a contrast analysis of imageological features.Methods Thirty-six patients who had postoperative pathological with Asian AIP standards and 95 patients who had postoperative pathological consistent with PC.The imageological results of these AIP and PC patients were analyzed.Results AIP was significantly less than PC in the enhanced CT of a mass or enlargement of the pancreatic head,enlargement of the lymph nodes around the pancreas,dilation and interrupt in pancreatic and bile duct,peripheral vascular and organ involvement (11/27 vs.28/40,2/27 vs.17/40,13/27 vs.32/40,1/27 vs.10/40,8/27 vs.26/40,2/27 vs.15/40,0/27 vs.15/40,0/27 vs.10/40,P ＜ 0.05).AIP was significantly more than PC in the enhanced CT of a diffusely enlarged pancreas,calcification or pancreatic calculus,capsule-like rim or the vague peripancreatic fat interval (4/27 vs.0/40,7/27 vs.0/40,10/27 vs.6/40,P ＜ 0.05).AIP was significantly less than PC in the three-dimensional ultrasonography of dilation diameter of pancreatic duct and dilation of common bile duct [(0.421 ± 0.270) cm vs.(0.594 ± 0.270) cm,1/18 vs.16/26,P＜ 0.05].AIP was significantly less than PC in the magnetic resonance cholangiopancreatography of dilation of common bile duct and interrupt in pancreatic duct (7/13 vs.16/18,1/13 vs.10/18,P ＜ 0.05).Conclusion AIP as a unique type of chronic pancreatitis can be distinguished from PC on distinctive imageological features