十二指肠乳头旁憩室伴胆胰疾病CT及MRI诊断

目的:探讨十二指肠乳头旁憩室伴胆胰疾病的CT和MRI诊断价值。方法:回顾性分析25例经临床随访证实的十二指肠乳头旁憩室伴胆胰疾病的CT和MRI表现,其中21例行CT平扫及增强,9例行MRI平扫、增强以及MRCP。结果:十二指肠乳头旁憩室CT及MRI表现壶腹周围含液气囊性病灶。MRCP表现为十二指肠内侧间壶腹部突出高信号囊性病灶。25例患者中合并胆胰病变CT和/或MRI表现为胆总管及肝内胆管结石13例,胆管扩张及壁增厚强化8例,胰腺肿胀3例,胰周脂肪层模糊4例及渗出2例,肾前筋膜增厚5例,胰管串珠样扩张2例。结论:CT及MR能显示十二指肠乳头旁憩室同时显示胆胰疾病引起胆管及胰腺形态学改变,有助于十二指肠乳头旁憩室伴胆胰疾病诊断。

CT and MRI diagnosis of periampullary duodenal diverticulum complicated with pancreaticobiliary diseases

Objective:To investigate the value of CT and MRI in diagnosis of periampullary duodenal diverticulum complicated with pancreaticobiliary diseases.Methods:CT and MRI manifestations of 25 patients with periampullary duodenal diverticulum complicated with pancreaticobiliary diseases,which was confirmed by clinical follow-up were retrospectively analyzed.21 patients underwent CT examination and 9 patients underwent MR imaging.Results:Periampullary duodenal diverticulum appeared as a cyst lesion with air and liquid near the periampullary area.At MRCP the diverticulum manifested as a high intensity signal cyst near ampulla of Vater.CT and MRI manifestations of pancreaticobiliary diseases included cholangiobiliary duct(CBD) and intrahepatic bile duct stone in 13 cases,dilatation of bile ducts and enhancement of thickening wall in 8 cases,swelling of pancreas in 3 cases,obliteration of peripancreatic fat in 4 cases,peripancreatic exudation in 2 cases,thickening of anterior renal fascia in 5 cases,beadlike dilatation of pancreatic ducts in 2 cases.Conclusion:CT and MRI can demonstrate periampullary duodenal diverticulum directly and morphological changes of pancreaticobiliary diseases,which is helpful in diagnosis of periampullary duodenal diverticulum complicated with pancreaticobiliary diseases.