慢性胰腺炎的CT诊断分型及其对鉴别诊断的意义

CT classification of chronic pancreatitis and the significance for differential diagnosis

目的探讨慢性胰腺炎CT表现特征,试图就其不同CT表现进行分型并探讨分型的意义。方法59例慢性胰腺炎,男43例,女16例,平均年龄40岁。36例有急性胰腺炎病史。常规上腹部CT平扫加增强,重点观察胰腺及病灶的大小、形态、密度等。结果27例(46%)表现为全胰腺萎缩型,均伴有不同程度胰实质钙化;13例(22%)表现为单发囊肿型伴囊壁不定型钙化;7例为多发囊肿型(12%)表现为胰腺及其周围多发假性囊肿;7例(12%)表现为单纯胰管扩张型;5例(8%)为肿块型,表现为局限性胰腺软组织样肿块,边缘清楚。结论慢性胰腺炎的CT表现可分为萎缩型、单发囊肿型、多发囊肿型、胰管扩张型和肿块型5型,CT诊断的分型对鉴别诊断及其病因的分析有一定的意义。

Objective To study the CT characteristics of chronic pancreatitis and a classification based on the CT manifestations was established. Methods In total 59 patients with chronic pancreatitis, 43 males and 16 females, with an average age of 40 years old were enrolled in the study. History of acute pancreatitis was positive in 36 patients. Non contrast enhanced and contrast enhanced CT scans were performed. The sizes of lesions, contour of pancreas, as well as the number, density and margin of lesions were investigated on the CT images. Results Atrophy of the entire pancreas was revealed in 27 patients （46%） , complicated with different degree of calcification. Solitary cyst with amorphous wall calcification was demonstrated in 13 patients （22%）; multiple intra-pancreatic and peri-pancreatic pseudo-cysts were shown in 7 patients （12 % ）; dilated pancreatic duct was seen in 7 patients （12 % ）; and regional well demarcated bulging of pancreas was presented in 5 patients （8%）. Conclusion The CT findings of chronic pancreatitis in our study could be classified into 5 types： atrophy type, solitary cystic type, multicystic type, pure pancreatic＇duct dilatation type and mass type. The classification had certain significance for the differential diagnosis and the etiological analysis of chronic pancreatitis.