自身免疫性胰腺炎胰腺外病变的CT表现

CT manifestation of extrapancreatic organs and tissues involved in autoimmune pancreatitis

目的分析自身免疫性胰腺炎(AIP)胰腺外器官受累的CT影像学表现特点,提高对AIP的认识及诊断水平。方法回顾性分析经临床随访及病理证实为AIP的9例患者的临床及影像资料。观察及分析胰腺外器官受累的影像特点,主要观察胰周血管、胆管及胆囊、肾脏、脾脏、肠系膜、腹膜后间隙等情况,并结合文献复习,探讨AIP胰腺外器官的CT表现特点。结果 AIP胰腺外病变的CT主要表现为:脾血管包埋变细3例,胆管壁增厚并管腔狭窄5例,肾脏受累3例,脾脏受累1例,腹膜后淋巴结肿大4例,肠系膜纤维化1例,胃脾韧带纤维化1例,腹膜后纤维化1例。经类固醇激素治疗后,CT复查显示胰腺内外病变均有不同程度好转。结论多器官受累是AIP的重要特征,其胰腺外CT表现具有一定特点,认识其表现有助于AIP的诊断。

Objective To explore CT features of extrapancreatic organs and tissues affected in Autoimmune pancreatitis （ AIP） , so as to improve the diagnostic level on AIP .Methods We retrospectively analyzed the clinical data and CT images of the nine patients , who were confirmed as AIP by clinical follow-up and pathology .We observed and analyzed the CT features of the organs and tissues involved in AIP .The main objects of the observation and analysis were peripancreatic vessels , bile duct and gall blader, kidney, spleen, mesentery and retroperitoneal space .And then wer discussed CT manifestation of extra pancreatic or-gans and tissues involved in AIP combined with the review of the literature .Results The CT main manifestation of extrapancreat-ic organs and tissues involved in AIP were as follows：splenic vascular embedding in 3 cases, thickness of bile duct wall and lu-men stenosis in 5 cases, renal involvement in 3 cases, splenic involvement in 1 case, retroperitoneal lymphadenectasis in 4 cases, mesentery fibrosis in 1 case, gastrolienal ligament fibrosis in 1 case, and retroperitoneal fibrosis in 1 case.After the treatment with steroids , CT reexamination showed that the focus inside and outside pancreas improved in different degrees .Conclusion Multiple-organ affected in AIP is an important feature of AIP, and the CT manifestations present some specific features .To recognizethese manifestations is helpful to the diagnosis of AIP .