慢性胰腺炎CT影像解剖学分型及其临床意义

CT imaging-anatomy type of total 213 chronic pancreatitis and its clinical significance

目的根据慢性胰腺炎CT表现的不同,探讨慢性胰腺炎的CT影像解剖学分型及分型的意义。方法收集1996年1月至2009年1月入住我院经临床或手术证实的213例慢性胰腺炎患者,其中男性156例,女性57例,平均年龄为(48.0±11.5)岁;平均住院天数(18.4±9.2)d;胆系疾病68例(32%),反复发作急性胰腺炎36例(17%)。常规肝胆脾胰平扫加增强(肝至肾动脉水平)。结果 213例慢性胰腺炎患者中,有69例(32.4%)表现为全胰腺萎缩型,31例(14.5%)表现为假性囊肿型,56例(26.3%)表现为胰管闭塞或扩张,18例(8.5%)表现局限性胰腺软组织样肿块,边缘清楚,39例(18.3%)为混合型,表现为胆、胰管扩张合并胰腺肿块或囊肿形成等。结论慢性胰腺炎CT影像主要可分为萎缩钙化型、假性囊肿型、胰管闭塞或扩张型、肿块型、混合型5型,CT诊断的分型对其诊断和鉴别诊断,以及其病因的分析有一定的意义。

Objective To explore CT imaging-anatomy type of chronic pancreatitis and their clinical significance based on the CT characteristics of chronic pancreatitis.Methods In total 213 cases of chronic pancreatitis patiernts,156 males and 57 females,with an average age of 48.0±11.5 years old and an average hospital day of 18.4±9.2 days were enrolles in the study.History of bile duct disease and acute pancreatitis were positive in 68 patients（32%） and 36 patients（17%） respectively.Non contrast enhanced and contrast enhanced CT scans were performed（with range from liver to kidney artery level）.Results 69 cases（32.4%） showed whole pancreas atrophic.Pancreatic pseudocyst was shown in 31cases（14.5%）.Pancreatic duct occlusion or dilated can be seen in 56 cases（26.3%）.18 cases（8.5%） for the mass type,showed local soft tissue samples of pancreatic tumors and 39 cases（18.3%） were mixed,appearance of dilated pancreatic duct or bile duct with pancreatic mass or pseudocyst etc.Conclusion The CT manifestations of chronic pancreatitis can be classified into 5 types： atrophy type,pancreatic pseudocyst type,pancreatic duct occlusion or dilatation type,mass type and mixed hybrid type.The classification had certain significance for the differential diagnosis and the etiological analysis of chronic pancreatitis.