MR胰胆管造影表现为四管征的慢性胰腺炎

MR cholangiopancreatography showed four-segment-sign of chronic pancreatitis

目的探讨MR胰胆管造影(MRCP)表现为四管征的慢性胰腺炎。材料与方法回顾性分析经手术病理证实的4例慢性胰腺炎的临床及影像学资料,4例术前均进行了CT增强扫描以及MRCP检查,其中1例进行了MRI增强扫描。结果 4例中3例为胰头部肿块型,1例未见明确肿块,CT增强各期显示病变与正常实质相比呈稍低密度肿块2例,呈等密度肿块1例,1例未见异常对比增强,1例MRI增强各期显示病变与正常实质相比呈稍低信号肿块,门静脉期可见胰管穿通征。4例MRCP均表现为四管征。结论慢性胰腺炎MRCP可表现为四管征,且以肿块型胰腺炎多见,四管征并非胰头癌特异征象,定性诊断有赖于CT或MRI增强扫描。

Objective：To investigate chronic pancreatitis whose MR cholangiopancreatography （MRCP） showed four-segment-sign. Materials and Methods：Retrospective analysis of pathologically conifrmed clinic and imaging data of four chronic pancreatitis cases, all of which had been undergone CT enhanced scanning and MRCP examination before surgery, and one case with further MRI enhanced scanning. Results：Three out of four cases have mass in the pancreatic head, one case no signiifcant mass, two cases showed slightly low density mass at each CT enhancement stage compared with normal parenchyma, one case equal density mass, one case no abnormal contrast enhancement, one case showed slightly lower signal mass at each MRI enhancement stage compared with the normal parenchyma with duct-penetrating sign at portal venous phase. All four cases showed the four-segment-sign in MRCP. Conclusions：MRCP of chronic pancreatitis can be expressed as four-segment-sign, more common occurrence in masstype focal pancreatitis. Four-segment-sign is not speciifc signs of pancreatic cancer, and further diagnosis is depends on enhanced CT or MRI scanning.