自身免疫性胰腺炎的多层螺旋CT表现(附5例分析)

MSCT Characteristics of Autoimmune Pancreatitis(Imaging Findings in Five Cases)

目的探讨自身免疫性胰腺炎(autoimmune pancreatitis,AIP)的多层螺旋CT表现。方法回顾性分析5例经病理证实或临床治疗后随访证实的自身免疫性胰腺炎的64层螺旋CT表现。结果 5例自身免疫性胰腺炎中3例(60%)胰腺弥漫性肿大,呈"腊肠状",其中1例(20%)胰头部明显肿大,疑似肿物形成。1例(20%)胰腺体尾部局限性肿大。1例(20%)胰腺未见明显肿大。3例(60%)胰周筋膜模糊,其中2例(40%)胰周见少许渗出性积液,1例(20%)胰周见低密度环状包膜影,即"胶囊征"。4例(80%)胰腺密度均匀。1例(20%)胰头部见斑点状钙化。5例(100%)胰腺中度均匀强化。4例(80%)胆总管胰腺段逐渐变窄,肝内外胆管"串珠样"改变,其中2例(40%)伴有胰管轻度扩张。1例(20%)仅表现胰管轻度扩张。2例(40%)累及单侧肾周筋膜,肾周筋膜模糊。1例(20%)累及单侧肾盂,表现为肾盂增大,内见低密度软组织肿块影,增强扫描肿块轻度强化。结论多层螺旋CT可以用于诊断自身免疫性胰腺炎,可用于评估胰腺外病变及胰腺治疗后改变。

Objective To evaluate the MSCT characteristics of autoimmune pancreatitis. Methods Five autoimmune pancreatitis patients confirmed by pathology or clinical were retrospectively analyzed by the 64-slice spiral CT. Results Diffuse swelling of pancreas was found in three patients, just as sausage-shaped. Among them one case of the pancreatic head show obvious swelling, suspected neoplasm. Obvious pancreatic body and tail swelling in one patient. No significant swelling of the pancreas in one patient. Minimal peripancreatic stranding in three patients, peripancreatic fluid collection in two patients, focal enlargement with a capsule-like rim in one patient. Four patients showed homogeneous pancreatic density. One patient can be seen calification in the the pancreatic head. Pancreas showed mild homogeneous enhancement in all five patients. Distal common bile duct stricture can be seen in four patients as string-of-beads changes, with slight expansion of the pancreatic duct in two patients. One patient only showing pancreatic duct mild expansion. Two patients with extraparenchymal renal involment, showing perirenal stranding. One patient with renal pelvis involment, showing low density inflammatory mass and mild homogeneous enhancement. Conclusionsonclusions MSCT can be used for the diagnosis of autoimmune pancreatitis, and also can be used to assess extrapancreatic lesions and pancreatic changes after treatment.