CAJ | 학술논문

目的：探讨局灶性自身免疫性胰腺炎（AIP）的CT和临床特征，提高该病与胰腺癌的CT鉴别能力。方法回顾性分析复旦大学附属肿瘤医院9例经病理证实的局灶性AIP及9例胰腺癌患者的动态增强CT特征和临床表现。局灶性AIP选择美国梅奥医学中心AIP诊断标准，均由穿刺活检或手术病理证实；胰腺癌均由手术病理证实。对比病灶在部位、形态、强化方式、胰管改变、胰周及胰腺外改变等方面的不同。结果9例局灶性AIP患者中，8例（88.9%）有局灶性胰腺肿大，1例（11.1%）外形正常。9例（100.0%）病灶均在CT平扫中呈相对低密度，8例（88.9%）增强后呈延迟强化，3例（33.3%）出现病灶远端胰管轻度扩张，以上特点与胰腺癌患者表现相比差异均有统计学意义。2例（22.2%）出现胰周包膜样改变。仅1例（11.1%）具有梗阻性黄疸及AIP合并硬化性胆管炎。3例（33.3%）有胰周淋巴结肿大。以上特征与胰腺癌患者表现相比差异无统计学意义。结论CT对局灶性AIP与胰腺癌的鉴别诊断具有一定价值。
목적：탐토국조성자신면역성이선염（AIP）적CT화림상특정，제고해병여이선암적CT감별능력。방법회고성분석복단대학부속종류의원9례경병리증실적국조성AIP급9례이선암환자적동태증강CT특정화림상표현。국조성AIP선택미국매오의학중심AIP진단표준，균유천자활검혹수술병리증실；이선암균유수술병리증실。대비병조재부위、형태、강화방식、이관개변、이주급이선외개변등방면적불동。결과9례국조성AIP환자중，8례（88.9%）유국조성이선종대，1례（11.1%）외형정상。9례（100.0%）병조균재CT평소중정상대저밀도，8례（88.9%）증강후정연지강화，3례（33.3%）출현병조원단이관경도확장，이상특점여이선암환자표현상비차이균유통계학의의。2례（22.2%）출현이주포막양개변。부1례（11.1%）구유경조성황달급AIP합병경화성담관염。3례（33.3%）유이주림파결종대。이상특정여이선암환자표현상비차이무통계학의의。결론CT대국조성AIP여이선암적감별진단구유일정개치。
Objective To investigate the CT imaging features of focal autoimmune pancreatitis (AIP) for the differential diagnosis of focal AIP and pancreatic carcinoma.Methods 9 patients with focal AIP and 9 patients with pancreatic carcinoma in Fudan University Shanghai Cancer Center were studied with the dynamic enhanced CT and analyzed retrospectively. Results Of the 9 focal AIP cases, CT showed pancreatic enlargement in 8 cases and normal in 1 case. All the lesions presented relatively low density on unenhanced CT. There were 8 cases with moderate enhancement on enhanced CT and 3 cases with mild dilatation of main pancreatic duct. The above characteristics had statistic differences. Two cases had peripancreatic capsule-like rim, 1 case had obstructive jaundice complicated with sclerosing cholangitis, and 3 cases had peripancreatic lymph node enlargement. The above characteristics were not statistically different.Conclusion CT imaging can provide useful information in differential diagnosis of focal AIP and pancreatic carcinoma.