IgG4相关性疾病的影像表现(附7例报告)

Imaging Manifestations of IgG4-Related Diseases(A Report of 7 Cases)

目的探讨IgG4相关性疾病的CT、MRI征象,旨在加深对该病影像征象的认识,提高影像诊断能力。方法回顾性分析7例IgG4相关性疾病的CT、MRI表现。结果CT检查2例胰腺受累及具有典型征象,4例不典型征象。胰周表现:2例假性囊肿,2例脾静脉受侵导致胰源性门脉高压伴胃底静脉曲张,5例胆管梗阻性扩张。胰外表现:3例胆囊肿大,1例门静脉“晕征”伴胆囊壁水肿,2例肾脏轻度强化结节灶,2例颌下腺肿大,1例右颌下腺肿大术后出现两侧泪腺对称性增大,1例两侧颌下腺肿大术后出现腹膜后纤维化,MRI检查2例胰腺弥散不受限,延迟强化,胰腺边缘“晕征”呈“假包膜征或胶囊征”,3例MRCP胰管节段性狭窄伴胆总管狭窄,1例MRI胸髓异常信号灶伴甲状腺弥漫性肿大。结论IgG4-RD累及多器官具有某些影像特征,准确掌握这些特征有利于提高影像诊断水平,降低影像误诊率。

Objective To investigate the CT and MRI signs of IgG4-related diseases,aiming to deepen the understanding of the imaging signs of the disease and improve the imaging diagnosis ability.Methods The CT and MRI manifestations of 7 cases of IgG4-related diseases were retrospectively analyzed.Results CT examination of 2 cases of pancreas involvement had typical signs and 4 cases of atypical signs.Peripancreatic manifestations:2 cases of pseudocysts,2 cases of splenic vein invasion leading to pancreatic portal hypertension with gastric varices,5 cases of obstructive dilatation of bile ducts.Extrapancreatic manifestations:3 cases of gallbladder enlargement,1 case of portal vein"halo sign"with gallbladder wall edema,2 cases of mild renal enhancement nodules,2 cases of submandibular gland swelling,1 case of right submandibular gland swelling with bilateral lacrimal glands after surgery Symmetrical enlargement,1 case of bilateral submandibular gland swelling developed retroperitoneal fibrosis after surgery,2 cases of MRI examination of the pancreas were unrestricted diffusion,delayed enhancement,pancreatic edge"halo sign"showed"false capsule sign or capsule sign",3 cases of MRCP pancreatic duct segmental stenosis with common bile duct stenosis,1 case of MRI thoracic cord abnormal signal foci with diffuse thyroid enlargement.Conclusion IgG4-RD involves multiple organs with certain imaging characteristics.Accurately grasping these characteristics is beneficial to improve the level of imaging diagnosis and reduce the rate of imaging misdiagnosis.