沟槽状胰腺炎的影像学特征分析

Imaging Features of Groove Pancreatitis

目的 探讨沟槽状胰腺炎(GP)的影像学表现特征,以提高对该病的诊断水平,从而选择更合理的治疗方案。方法 回顾性分析2010年1月至2021年3月经手术病理或活检病理检查确诊的13例GP患者的影像与临床资料,其中男10例,女3例,年龄32~64岁。13例患者均行CT平扫及增强扫描;MRI平扫5例,其中4例同时行MRI平扫及增强扫描。结果 所有13例患者均可见沟槽区条片状软组织增厚改变,CT平扫呈等或混杂稍低密度,MRI平扫T_(1)WI序列呈低信号,T_(2)WI序列呈等或稍高信号,动脉期呈轻度强化或无强化,延迟期呈渐进性不均匀延迟强化。13例表现为十二指肠降部肠壁不同程度增厚及沟槽区积液,9例表现为十二指肠降部肠壁的囊性变及肠腔狭窄。3例患者胰头内CT见稍低密度影,T_(1)WI序列为等或稍低信号,T_(2)WI序列为等或稍高信号。2例主胰管及胆总管轻度扩张,胆总管下段渐进性狭窄伴中上段扩张。2例胰周淋巴结肿大。结论 GP的影像表现具有一定特征性,熟悉这些表现特点,可以帮助临床医师尽早选择更合适的治疗措施,减少不必要的手术。

Objective To investigate the imaging features of groove pancreatitis(GP)to improve the diagnostic level of this disease and select a more reasonable treatment.Methods We retrospectively analyzed the imaging and clinical data of 13 patients with GP diagnosed by surgical or biopsy pathology from January 2010 to March 2021,including 10 males and 3 females,aged from 32 to 64 years.All the patients were examined by plain and contrast⁃enhanced CT scans.MRI plain scan was performed in 5 cases,4 cases of whichwere examined by contrast⁃enhanced MRIscan after that.Results Piece⁃likesoft tissue thickening in the groovearea was found in all13 cases,with isodensityor mixedslightly low density on plain CT scan,low signal on T_(1)WI and iso⁃or slightly high signal on T_(2)WI.It showed mild or no enhancement in the arterial phase and progressive heterogeneous delayed enhancement in the parenchymal phase.13 cases showed the varying degrees of intes⁃tinalwall thickeningin the descendingpart of the duodenumand fluid accumulation in the groove area,and 9 cases showed cystic change of the descending part of the duodenumand and intestinal stenosis.Three cases showed slightly low density shadows in the head of the pancreas on CT scans,with T_(1)WI sequences showing equal or slightly low signals,and T_(2)WI se⁃quences showing equal or slightly high signals.There were mild dilatation of the main pancreatic duct and common bile duct in 2 cases,with progressive stenosis of the lower segment of the common bile duct and dilatation of the middle and upper segments of it.Two cases had peripancreatic lymph node enlargement.Conclusion The imaging features of GP have cer⁃tain characteristics.Being familiar with these features can help clinicians choose more appropriate therapeutic measures as early as possible and reduce unnecessary operations.