IgG4相关腹部疾病的临床及影像学表现

目的 探讨IgG4相关腹部疾病的临床及影像学表现,提高对该病的认识及诊断水平.方法 回顾性分析2012年10月至2021年1月首都医科大学附属北京佑安医院28例IgG4相关腹部疾病的临床及影像学资料.结果 腹部多个器官(2～5个)受累多见,胆管(100.0％)和胰腺(85.7％)最常受累.胆管受累复杂多样,胆总管下段受...

Clinical and imaging features of IgG4 related abdominal diseases

Objective To investigate the clinical and imaging manifestations of IgG4 related abdominal diseases in order to improve the understanding and diagnostic level of the disease. Methods The clinical and imaging data of 28 patients with IgG4 related abdominal diseases were retrospectively analyzed. Results Multiple (two to five) abdominal organs were frequently involved, and the most commonly involved organs were biliary tract (100.0%) and pancreas (85.7%). The involvement of biliary tract was complex and varied. The involvement of the lower bile duct was the most common, which was often associated with pancreatitis. Hilar and intrahepatic bile duct involvement was rare, hilar bile duct involvement was often complicated with intrahepatic inflammatory pseudotumor. Bile duct involvement showed wall thickening with delayed enhancement and the lumen was thread-line narrow. Diffuse enlargement of the pancreas was common, surrounded by “capsule like” pseudocapsule, shaped like sausage. The signal intensity of pancreas was diffusely decreased on T1WI fat pressure sequence, and high signal intensity on DWI, low signal intensity on ADC and gradually delayed enhancement. The focal type of enlargement was mainly the enlargement of the head and tail of the pancreas, with mild dilatation of the pancreatic duct in the body. Gallbladder involvement manifested uniform wall, non-edematous thickening and delayed enhancement. The lymph nodes in retroperitoneum and around the involved organs were mostly slightly enlarged, isolated, not fused, and uniformly enhanced. Urinary system involvement is rare, mostly involving both sides, showing single or multiple mass like and enhancement decline in renal parenchyma, soft tissue density shadow surrounding the renal pelvis, ureteral wall thickening with upper hydronephrosis and dilatation. Conclusion The imaging features of IgG4 related abdominal diseases have certain characteristics. The imaging characteristics, combined with clinical manifestations, laboratory examination and histopathological analysis, are helpful to make an accurate diagnosis.