沟槽区胰腺炎的MRI征象分析

MR sign analysis of groove pancreatitis

目的探讨沟槽区胰腺炎(groove pancreatitis,GP)的磁共振影像特征及鉴别诊断要点。方法采用磁共振扫描仪对7例患者进行检查后经过手术病理,分析沟槽区胰腺炎患者的磁共振影像及临床病理资料。结果平扫7例患者均表现为不同程度的胰头区团块影,与十二指肠降段分界不清,T1WI呈不均匀低信号;T2WI呈不均匀高信号。其中,胆总管梗阻3例,胰头及周围炎性改变4例,合并囊性变者6例。增强扫描动脉早期见正常胰腺组织与十二指肠黏膜明显强化,胰腺边界清楚;动脉晚期及门静脉期见上述团块不均匀轻-中度强化,上述小囊性病灶无强化,延时期(5min)上述团块进一步明显不均匀强化,囊性病灶边缘见环形明显强化。结论GP是一种少见但易于误诊的慢性炎性疾病,MR检查有典型的影像特征,正确认识其特征性是诊断的关键。

Objective To evaluate the MRI feature and differential diagnostic points of groove pancreatitis(GP),for summing up the experience and improving the diagnostic efficiency.Methods MR and pathological files of seven patients with GP confirmed by surgical pathology were analyzed retrospectively.All the patients were male,and the age ranged from 29 to 62 years.Results On plain scan images,all the patients showed varying degrees of pancreatic head region masses,witch could not be separated clearly with duodenum.All the lesions showed uneven low signal on T1WI,and uneven high signal on T2WI.3 cases presented with common bile duct obstruction,4 cases with inflammatory change of the pancreatic head and surrounding,and 6 cases with cystic change.On enhanced scan images,the duodenal mucosa and normal pancreatic tissue were significantly enhanced and the pancreas boundary was clear in earlier artery phase.Conclusion GP is a kind of rare but easily misdiagnosed chronic inflammatory disease.The key of correct diagnosing is to understand its characteristic pathogenesis and typical imaging features.