自身免疫性胰腺炎CT、MRI表现及诊断

Imaging findings and diagnostic value of CT and MRI for autoimmune pancreatitis

【目的】探讨CT与MRI检查对自身免疫性胰腺炎(autoimmune pancreatitis,AIP)的诊断价值。【方法】回顾分析2010年9月至2016年6月天津市人民医院收治的16例确诊为AIP的临床及影像学资料。【结果】16例患者中,CT及MRI检查分别可见14/12例胰腺肿大,合并肾脏多发病变3例;胰腺周围环绕增厚的包膜样结构CT可见4例,MRI检查可见10例;胰管局限性狭窄CT未发现,MRI可见6例;胆管狭窄CT检查可见5例,MRI检查可见11例。CT及MRI检查对于胰腺形态改变、肾脏病变的检出率一致,但对于胰胆管病变及假包膜形成的显示,MRI较CT有明显优势(P<0.05)。【结论】AIP的影像学检查具有一定的特征性,对于临床诊断有重要价值;相对于CT,MRI对于AIP的特征性表现具有更高的检出率,可作为临床首选。

[ Objective ] To investigate the diagnostic value of CT and MRI for autoimmune pancreatitis （AIP）. [ Methods ] The clinical and imaging data of 16 cases with AIP in Tianjin People＇s Hospital were retrospectively analyzed from September 2010 to June 2016. [Results] The imaging findings of CT and MRI showed that 14/12 AIP patients appeared pancreas enlargement; 3 patients were combined with muhiple renal diseases; capsule-like rim around pancreatic parenchyma was found under CT （4） and MRI （10）. The pancreatic-duct stenosis was found under CT （0） and MRI （6）, while the stenosis of bile duct was found under CT （5） and MRI （11）. The detection rates of CT and MRI are consistent in finding morphological changes of pancreas and kidney diseases. However, MRI had more advantages in the display of pseudocapsule around the pancreatic parenchyma and the diseases of pancreatic duct and bile duct （P〈 O.O5）. [Conclusion] The imaging features of AIP are helpful for the clinical diagnosis. Compared with CT, MRI is of higher detection rate for the characteristics of AIP. Therefore, it can be the best choice.