胃壁及胃周异位胰腺的CT影像学研究

CT imaging study of heterotopic pancreas in the gastric wall and perigastric fat tissue of human

目的研究人胃壁异位胰腺及胃周异位胰腺的CT影像学特征,为CT诊断异位胰腺提供理论基础。方法回顾性分析40例经术后病理证实的胃部异位胰腺CT资料,其中21例进行了增强CT扫描。于PACS系统上进行图像分析。结果胃壁异位胰腺24例,病灶多数位于胃窦部或胃大弯侧或混合型,表现为圆形、卵圆形或不规则形的粘膜下病变,可伴有中央脐凹征或囊性变,表面粘膜增厚或破溃。Ct增强后表现为高于、类似或低于正常胰腺的强化方式。胃周脂肪内异位胰腺16例,10例为多发病灶。胃周脂肪内异位胰腺均表现为圆形或椭圆形小结节,境界清楚,强化程度类似于周围淋巴结。结论胃壁异位胰腺CT表现有其特征性,可为临床诊断提供影像学依据,胃周异位胰腺应注意与胃周淋巴结鉴别。

Objective To study the image of heterotopic pancreas in the gastric wall or perigastric fat tissue of human by computed tomography（CT） to provide the basis for the diagnosis of the heterotopic pancreas. Methods The images of 40 cases of gastric heterotopic pancreas identified by postoperative pathology were studied by nonenhanced CT in 19 cases and enhanced CT scanning in 21 cases, and analyzed by PACS system. Results 24 cases of heterotopic pancreas were found to be located in submucosa of the gastric wall with round, ovoid or irregular shape, in the gastric antrum（ n= 19） or the greater curvature of the stomach in most of the cases, a few with the central umbification sigh and cystic degeneration. The CT enhanced degree was higher, similar, or lower in heterotopic pancreas than in normal pancreas. 16 cases of heterotopic pancreas were found in the perigastric fat tissue, with round or oval small nodules. Conclusion Heterotopic pancreas in the gastric wall could be diagnosed accurately by CT, but need pay attention to identify the perigastric heterotopic pancreas with lymph nodes.