背胰形态变异的影像学特征

Imaging features of anatomical variations of the dorsal pancreas

目的总结背胰形态变异的影像学特征及其临床意义。方法回顾性分析47例背胰形态变异患者的CT、MRI资料，分类解释其影像学特征。结果（1）背胰缩小类。背胰发育不全（n=7）：胰腺长度（91．59±22．39）mm，呈“短胰腺”表现，4例（4／7）胰头增大，存留胰腺呈“蝌蚪状”，其中3例（3／7）形成环状胰腺；2例（2／7）合并多脾综合征、下腔静脉肝段缺如。（2）背胰增大类。①胰尾增宽（n=18）：胰尾最大宽径（36．12±6．59）mm，超过胰体宽径，胰腺呈类似“哑铃状”表现。②背胰局部隆起（n=13）：胰颈、体及尾部腹侧缘的局限性隆起，高度（15．72±2．65）mill，长度（18．59±3．64）mm，多位于胰颈。（3）背胰相关分裂类。①背胰脂肪裂隙（n=7）：脂肪裂隙宽度（3．51±2．42）mm，深度（19．45±5．84）mm，表现为线条状脂肪密度（信号）影，5例（5／7）位于胰体、尾，2例（2／7）位于腹胰与背胰融合区。②胰尾分叉（n=3）：胰尾局限性分叉呈“燕尾状”表现，最大宽径（26．63±1．75）mm，分叉角度（99．27±30．73）度。结论背胰发育异常可导致胰腺多种形态改变，影像学表现有一定特征，了解胰腺的发育过程，熟悉该类变异的影像学表现有助于正确诊断，从而避免不必要的临床治疗。

Objective To evaluate imaging features and clinical significance of anatomical variations of the dorsal pancreas. Methods CT and MR imaging data of 47 cases with variations of the dorsal pancreas were collected. Imaging characteristics of the dorsal pancreas were analysed. Results （1） Narrow dorsal pancreas：the agenesis of dorsal pancreas （7 cases） appeared as “short pancreas”, their length was （91.59± 22.39） ram. 4 cases of pancreatic head volume increased, with “tadpole-like” retention of the pancreas, including 3 cases of annular pancreas. 2 cases with polysplenia syndrome and congenital abscence of the hepatic segment of inferior vena cava. （ 2 ） Abnormaly enlarged dorsal pancreas ： ①the broadening of the pancreatic tail （n = 18 ） ： the maximum diameter of pancreatic tail was （36. 12 ± 6. 59） mm, the pancreas was similar to the “dumbbell-shaped”. ②Processes locally of pancreatic contour （ n = 13 ）, which were local process at the ventral aspect of pancreas, the height was （ 15.72 ± 2. 65 ） mm, the width was （ 18. 59 ± 3.64 ） mm, most often seen on the neck of the pancreas. （3） Dorsal pancreas related divisium：①Pancreas separated by fat spatium （n =7）, the width was （3.51 ±2.42）, the deepness was （19.45±5.84）, it showed the crack-like fat density （signal） shadow, 5 cases （5/7） located in the pancreatic body and tail, 2 cases （2/7） located at the junction of ventral pancreas and dorsal pancreas. ②The bifurcation of the pancereatic tail （ n = 3 ）, limitations forked tail of the pancreas was “dovetail-like” performance. The maximum width diameter was （26. 63 ± 1.75 ） ram, the bifurcation angle was （99. 27 ± 30. 73） degrees. Conclusions The developmental anomalies of dorsal pancreas can lead to a number of variations of pancreas, some of which carl induce corresponding disease and be mistaken for neoplasm.