胰尾增宽:一种少见的胰腺变异

The broadening of the pancreatic tail:a rare variation of the pancreas

目的提高对胰尾增宽的认识水平。方法遴选过去10年间28例胰尾增宽病例CT、MRI资料,复习文献,提出其诊断和鉴别要点。结果①胰尾增宽(n=24):胰尾最大前后径≥3.0 cm,明显超过最大高径和胰体前后径;②胰尾分叉(n=4):横断面像上,3例脾静脉穿行于增宽的胰尾内,1例重复畸形者,分叉的胰尾内有独立的胰管。结论胰尾增宽并不少见,因缺乏认识,常被误诊为"胰腺肿块"。胰尾增宽的影像诊断标准:①横断面图像上,胰尾最大宽径≥3.0 cm,明显超过胰尾最大高径和胰体宽度;②平扫及增强扫描像上,增宽的胰尾质地与正常胰腺组织一样;③增宽胰尾内的胰管结构、粗细、走行正常。

Objective To raise clinical recognition of the broadening of pancreatic tail.Methods Twenty-eight cases of the broadening of the pancreatic tail were selected in the past 10 years,and the key points of diagnosis and differentiation were proposed.Results 1 The broadening of the pancreatic tail（n=24）： the largest anteroposterior diameter of the pancreatic tail was greater than 3 cm and significantly exceeded the largest diameter of the height and the anteroposterior diameter of the body of pancreas;2 The bifurcation of the pancereatic tail（n=4）： on transverse images,splenic vein crossing through the pancreatic tail was found in 3 cases,the independent pancreatic duct in the bifurcation of the tail of pancreas was found in 1 other case.Conclusion The broadening of the pancreatic tail is not rare,which contains irregularities,bifurcation,spindle pattern and drumstic mode on the transverse image,and can be misdiagnosed as the mass of the pancreas.The diagnosis standard image for the broadening of the pancreatic tail on transverse image is as following： 1 the largest diameter of the broadening of the pancreatic tail is greater than 3 cm and significantly exceeds the height of the body of pancreas;2 the density of the broadening of the pancreatic tail is similar to the other portion of the pancreas according to the plain scanning and contrast enhancement scanning;3 the structure,diameter and direction of pancreatic duct are normal in the broadening of the pancreatic tail.