摘要
目的观察IgG4相关硬化性胆管炎(IgG4-SC)的CT和磁共振胰胆管造影(MRCP)影像表现。方法回顾性分析9例IgG4-SC患者的临床及影像资料,观察IgG4-SC初始病变的CT和MRCP特征及随访变化。结果初始病变:6例CT扫描显示肝外胆管胰腺段管壁增厚,其中2例伴有胰上段胆管壁偏心性增厚,增厚的胆管壁呈渐进性强化;7例MRCP检查中,6例显示肝外胆管胰腺段狭窄,1例肝内胆管狭窄和肝外胆管胰腺段狭窄,狭窄近侧的胆管呈中度至重度扩张。随访:5例未接受类固醇治疗以及2例治疗后复发的患者胆管病变均较初始加重。8例随访患者中,无论治疗及时与否,或是病变复发后再治疗,应用类固醇后胆管病变均显著好转。结论 IgG4-SC的CT和MRCP表现为胆管壁增厚、管腔狭窄和近侧胆管扩张,类固醇治疗后病变明显好转。
Objective To observe CT and magnetic resonance cholangiopancreatography （MRCP） features of IgG4-related sclerosing cholangitis （IgG4-SC）. Methods CT and MRCP appearances of 9 patients with IgG4-SC were analyzed retro- spectively, including initial lesion characteristics and lesion changes in follow-up with or without clinical steroids therapy. Results In aspect of initial lesions, 6 cases of CT scans showed the intra-pancreatic bile duct wall thickening, 2 cases with upper bile duct eccentric thickening were among them, the thickened bile duct wall was gradually strengthened following in- travenous administration of iodine contrast, among 7 cases of MRCP examinations, 6 cases showed intrapancreatic bile duct stenosis, 1 case showed intrahepatic and intrapancreatic bile duct stenosis, the proximal bile duct showed moderate to se- vere dilatation. In aspect of lesion changes in follow-up, the bile duct lesions were aggravated in 5 cases who did not receive steroid therapy and 2 relapsed cases. In follow-up of 8 cases, no matter the treatment was timely or not, regardless of re- treatment after the disease recurrence, the bile duct lesions improved significantly after administration of steroids. Conclu- sion CT and MRCP features of IgG4-SC include bile duct wall thickening and luminal stenosis with proximal bile duct dila- tation, and the lesions improve markedly after steroid therapy.
出处
《中国介入影像与治疗学》
CSCD
北大核心
2015年第6期336-340,共5页
Chinese Journal of Interventional Imaging and Therapy
