CT与MRI对沟槽状胰腺炎的诊断价值

Diagnostic value of CT and MRI on groove pancreatitis

目的:探讨沟槽状胰腺炎的CT与MRI的影像表现及其诊断价值。方法:对3例疑诊为胰头肿块而行胰十二指肠切除,但术后病理学检查证实为沟槽状胰腺炎患者的CT与MRI影像及临床资料进行回顾性分析。结果:3例沟槽状胰腺炎患者的CT与MRI均在胰头和十二指肠之间见团块影。CT均表现为低密度;MRI T1WI均呈低信号,2例T2WI呈低信号,1例T2WI呈高信号。3例CT与MRI增强后均呈渐进性强化,均表现为不同程度十二指肠壁增厚伴有管腔狭窄。结论:沟槽状胰腺炎极易误诊为胰腺癌;但沟槽状胰腺炎患者多有长期饮酒史,黄疸呈波动性,主胰管不受损害,胆总管呈渐进性狭窄,CT与MRI增强扫描肿块呈延迟、渐进性强化、不均匀强化的特征有利于与胰腺癌鉴别。临床及影像表现有助于明确诊断。

Objective： To investigate the imaging findings and diagnostic value of CT and MR on groove pancrea- titis. Methods： The CT, MRI, and clinical data of 3 subject were analyzed retrospectively,which were suspected a mass of the pancreatic head but were proved pathologically to be groove pancreatitis after the pancreas and duode- num resectionely. Results： CT and MR images showed a mass between the head of pancreas and the duodenum in all 3 cases. The mass appeared as low density on CT images and low signal intensity on MR T~ WI images, low sig- nal intensity on MR T2WI images in 2 cases and high signal intensity in the rest one, gradual enhancement on con- trast- enhanced CT and MR images. Thickened duodenal wall with narrowed lumen were observed in the three ca- ses. Conclusion： Groove pancreatitis is easily misdiagnose as pancreatic carcinoma, but the following information will be helpful for differentiation from pancreatic cancer： patients with groove pancreatitis usually has a long-term alcohol drinking history, fluctuating jaundice, sparing main pancreatic duct, and gradual stenosis of common bile duct, and mass on contrast-enhanced CT scan and MRI shows gradual, delayed, and nonhomegeneous enhance- ment.