胰头变形的CT表现及临床意义

CT findings on disfiguration of the pancreatic head and its clinical significance

目的探讨胰头变形的CT表现及临床意义。方法分析经手术、病理检查证实的10例胰头变形患者的CT影像资料。结果胆总管下端癌4例,表现为胰头明显增大/变形,胆道系统显著扩张,胆总管扩张,胆总管下端突然中断、狭窄、胆管壁增厚;胰头癌4例,表现为胆道系统扩张,胰头局限增大,轮廓改变,主胰管扩张、中断,远端胰腺萎缩;胰腺慢性炎症2例。表现为胆道系统轻度扩张,胰体尾部萎缩,胰头增大,外形光整。结论胰头变形的原因有胆总管下端癌、胰头癌、慢性胰腺炎等,仔细分析其影像学表现有助于鉴别诊断。

Objective To evaluate the CT findings on disfiguration of the pancreatic head and its clinical significance. Methods To analyze the CT manifestations of pancreatic head disfiguration corroborated by surgical findings and pathological examinations in 10 patients. Results Among the 10 cases, there were 4 cases of carcinoma in the inferior extremity of the common bile duct,whose CT findings consisted of obviously augmented pancreatic head, remarkably dilated biliary system, dilated common bile duct, and unexpected discontinuance and stenosis in the common bile duct. CT findings on 4 cases of carcinoma in the pan- creatic head were presented as dilated biliary system,local augmented pancreatic head, distension and discontinuance in the main pancreatic duct,and atrophy in distal pancreas. CT findings on 2 cases of chronic pancreatitis were presented as mildly dilated biliary system, atrophy in the body and tail of the pancreas, enlarged pancreatic head with derased contour and calcification in it. Conclusion The causes of disfiguration of the pancreatic head are considered due to carcinomas in the inferior extremity of the common bile duct or the head of the pancreas,chronic pancreatitis etc. Carefully analysis of imageological findings on disfiguration of the pancreatic head is helpful to differential diagnosis.