十二指肠异位胰腺导致胆道梗阻的CT诊断及临床特征分析(2例报告)

CT diagnosis and clinical features of biliary obstruction induced by heterotopic pancreas of duodenum: A report of 2 cases

目的总结十二指肠异位胰腺的CT表现,增强对本病影像表现的认识。方法回顾性分析2013年10-11月我院收治的2例十二指肠异位胰腺患者的临床资料及影像表现。结果 2例均为男性,年龄分别为33岁、41岁。2例均无明显诱因出现上腹痛;1例伴后背放射痛、偶有腹胀,另1例伴恶心、呕吐。CT显示病变累及十二指肠降段肠壁,表现为肠壁不规则增厚,肠腔变窄,病灶内可见管状囊性密度影;胰腺胰管、胆总管扩张。增强扫描动脉期、门静脉期病变实质部分明显强化,与胰腺实质强化幅度相近;囊性部分未见强化。胰头实质密度欠均匀,周围脂肪间隙模糊。结论十二指肠异位胰腺CT表现具有一定特征性,结合临床病史可以作出正确诊断。

Objective To improve the understanding of the imaging features of ectopic pancreas of duodenum by summarizing its CT findings. Methods Clinical data and imaging features of 2 patients with ectopic pancreas of duodenum admitted to our hospital from October 2013 to November 2013 were retrospectively analyzed. Results The 2 male patients were 33 and 41 years old respectively. They had upper abdominal pain with unknown reasons. One was accompanied with radiation backache and occasional abdominal distension while the other was accompanied with vomiting and nausea. CT scanning showed that the lesion involved the descending duodenum wall, which manifested as irregular thickening of the duodenum wall and stenosis of the duodenum cavity, with a tubular cystic density shadow in the foci and dilated pancreatic and common bile ducts. The parenchyma of lesion was significantly enhanced at the conventional arterial and venous phases, which was similar to the enhanced pancreatic parenchyma. However, there showed no enhancement of the cystic part of pancreas. The density in parenchyma of pancreatic head was uneven and the fatty space was unclear around the duodenum. Conclusion Ectopic pancreas of duodenum can be diagnosed according to its certain characteristics detected by CT scanning in combination with its clinical history.