沟槽区胰腺炎多层螺旋CT征象分析

目的:探讨沟槽区胰腺炎的MSCT征象,提高对该病的影像学诊断水平.方法:回顾性分析53例GP患者的临床及CT影像学资料,所有病例经手术病理或ERCP活检病理证实.观察沟槽区肿块或囊状病变的强化特点和分型,以及邻近结构的影像学改变.结果:53例的主要CT表现:①均可见沟槽区软组织增厚改变,CT平扫呈等或混杂稍低密度,动脉期呈轻度强化或无强化,实质期呈渐进性不均匀延迟强化;②57％(30/53)伴有副胰管开口邻近十二指肠降部肠壁或胰头实质的囊性变(长径10～48 mm);③十二指肠降部肠壁增厚45例(85％),其中40例为弥漫性水肿,5例为局部性水肿;④胰管扩张占19％(10/53),胆总管扩张占15％(8/53);⑤其它:沟槽区积液占89％(47/53),淋巴结炎(短径8～17 mm)占23％(12/53).结论:沟槽区胰腺炎的MSCT征象具有一定特征性,双期增强扫描对本病的诊断具有重要价值.

Analysis of multi-slice CT features of groove pancreatitis

Objective:To study the MSCT features of groove pancreatitis (GP),thus to improve diagnostic accuracy of imaging examination in this disease.Methods:Retrospective review of preoperative CT findings and clinical data in 53 patients with pathologically proven GP after pancreaticoduodenectomy or endoscopic retrograde cholangiopancreatography (ERCP).Category and attenuation of groove lesion,associated with the CT imaging performance of the second part of duodenal,bile common duct,pancreatic duct,lymph node and vessels were evaluated and collected.Results:The main CT features of GP were as follows:①soft tissue thickening in the groove was seen in all 53 patients,the lesions was isodense or blended hypodense on pre-contrast images,It showed slight or no enhancement in arterial phases and continuous patchy delayed enhancement during the parenchymal phases.②57％ (30/53) cystic dystrophy at the adjacent region of the Santorini duct in the second part of duodenum or in the pancreatic parenchyma (diameter of 10～48mm).③Wall thickness in the descending duodenum was seen in 85％ (45/53) patients,with a general or local edema by 75％ (40/53) and 10％ (5/53) respectively.④Abnormality of the bile duct dilatation in pancreas was identified by 19 ％ (10/53) and common bile duct was observed by 15％ (8/53).⑤Other:Fluid collection of the groove area was identified in 89％ (47/53) patients.Lymphade nopathy was observed in 23％ (12/53) patients (ranging from 8～ 17mm in short dimension).Conclusion:The MSCT features of groove pancreatitis are relatively specific,dual-phase study can be a valuable reference for the clinical diagnose.