胰腺少罕见病变的影像学诊断

Radiological Diagnosis of Uncommon or Rare Pancreatic Diseases

影像学检查在胰腺疾病的诊断中扮演着重要的角色。大多数放射科医师对急性胰腺炎、慢性胰腺炎以及胰腺导管上皮腺癌等常见疾病的影像学表现比较熟悉。本文从病因、病理学、临床一般情况以及影像学表现等角度讨论胰腺少罕见的诊断及鉴别诊断。本文把胰腺少罕见病变分为三类 ,即胰腺先天性病变、胰腺少罕见炎症性病变及胰腺少罕见肿瘤。胰腺先天性病变包括异位胰腺、环状胰腺、先天性胰腺分裂、先天性背胰缺如、胰腺囊性纤维化及胰腺内副脾等。胰腺少罕见炎症性病变包括胰腺脓肿、胰腺炎性肿块、自身免疫性胰腺炎、特发性纤维性胰腺炎及胰腺结核等。胰腺少罕见肿瘤包括胰腺内分泌肿瘤、胰腺囊性上皮源性肿瘤、胰腺间叶组织肿瘤以及其他胰腺少罕见肿瘤。部分胰腺少罕见病的影像学表现颇具特征性 ,影像学检查可以作出较明确的诊断 ;另一些胰腺少罕见病根据影像学表现难以作出明确诊断 。

Medical imaging has played an important role in the diagnosis of pancreatic diseases.Most radiologist are familiar with the radiological findings of common pancreatic diseases such as acute pancreatitis,chronic pancreatitis,and pancreatic adenocarcinoma.Uncommon and rare diseases of the pancreas are discussed on their etiology,pathology,clinical manifestations and radiological appearances in this review.Uncommon or rare diseases of the pancreas are classified into 3 categories.Congenital pancreatic diseases include heterotopic pancreas,annular pancreas,congenital unfuseal pancreas,congenital agenesis of the dorsal pancreas,cystic fibrosis,and intrapancreatic accessory spleen.The uncommon or rare inflammatory diseases include pancreatic abscess,inflammatory mass,autoimmune pancreatitis,idiopathic fibrosing pancreatitis,and pancreatic tuberculosis.The uncommon or rare pancreatic tumors embrace pancreatic endocrinal neoplasms,pancreatic cystic epithelial neoplasms,pancreatic mesenchymal tumors,and the other uncommon or rare pancreatic neoplasms.Some uncommon or rare pancreatic diseases show characteristic radiological manifestations and get confirmed diagnosis.While the others are difficult to characterize,and bioptic procedures are needed.