自身免疫性胰腺炎的临床及MSCT诊断

Autoimmune pancreatitis: clinical and MSCT diagnosis

目的探讨自身免疫性胰腺炎(Al P)的MSCT表现,旨在提高临床诊断水平。方法回顾性分析16例自身免疫性胰腺炎的临床、MSCT影像特征。结果病变分为弥漫型和局限型;其中弥漫肿胀12例(75.0%),局限肿胀4例(25.0%);病灶大部分表现为轻-中度均匀强化及延期强化特点;15例胰腺病变区出现鞘膜样结构(68.8%);胰管狭窄7例(43.8%),狭窄程度不一;出现脾血管受累2例(12.5%);出现胆管狭窄15例(93.8%);1例AIP伴有双肾受累。结论自身免疫性胰腺炎具有一定特征性MSCT影像学改变,图像后处理有利于病变细微结构的显示,综合分析MSCT征象有利于提高其诊断准确率。

Objective To explore MSCT manifestations of autoimmune pancreatitis （AlP） and to improve the awareness and correct diagnosis rate of AIP. Methods Clinical and MSCT features in 16 cases of AlP were analyzed retrospectively. Results The lesions were divided into diffuse and limited types; There were 12 cases （75.0%） in the diffuse swelling and 4 cases （25.0%） of the limited swelling. Most of lesions showed mild-moderate range homogencous enhancement and delayed strengthening. 15 cases of pancreatic lesion showed capsule-like rim around the pancreatic parenchyma （68.8%）. There were 7 cases of pancreatic duct stenosis （43.8%） with varying degrees of stenosis and 2 cases of splenic vascular involvement （12.5%）; There were 15 cases of biliary stricture （93.8%）; One case of AIP was associated with double renal involvement. Conclusion AIP shows the characteristics features in the MSCT manifestations, the MSCT image-postprocessing is very helpful for lesion demonstration, and comprehensive analysis of all the MSCT features will help to improve diagnosis.