消化道异位胰腺CT表现

目的:分析消化道异位胰腺CT特征。方法:回顾性分析经病理证实25例消化道异位胰腺CT表现,其中14例行CT增强检查。根据病变部位和临床症状,将消化道异位胰腺CT表现分为:黏膜下型、梗阻型、憩室型和溃疡型。结果:①25例异位胰腺均为单发病灶。胃部12例,十二指肠7例,小肠6例(空肠4例,回肠2例)。②黏膜下型异位胰腺:胃部7例,发生在胃窦部大弯侧;十二指肠2例,位于球部。梗阻型:胃部3例,病变位于幽门管;十二指肠2例,位于壶腹周围区,胆总管梗阻;空肠3例,1例发生肠套叠。溃疡型:胃部2例,见中央脐凹征;十二指肠2例,位于球部。憩室型:十二指肠1例,位于乳突部;空肠1例;回肠2例,近回盲部。③病理显示Ⅰ型6例,Ⅱ型14例,Ⅲ型5例。在增强检查14例中11例类似正常胰腺强化,病理为Ⅰ型或Ⅱ型;3例强化不明显,病理为Ⅲ型。结论:消化道不同部位异位胰腺有不同CT特征,CT不同表现与异位胰腺病理组成相关,CT检查有助于对本病的正确诊断。

CT Findings About Heterotopic Pancreas in the Alimentary Tract

Objective: To analyze CT findings about ectopic pancreas in the the alimentary tract.Methods: CT findings of 25 cases with ectopic pancreas in the alimentary tract confirmed by pathology were reviewed,in which 14 were enhanced CT scans.Their CT features associated with the location and clinic manifestation were divided into four types as submucosa,obstruction,diverticulum and ulcer types.Results: ① All cases were mono-lesion,including 12 in the stomach,7 in duodenum and 6 in small intestine(2 in the ileum and 4 in the jejunum).② Of the submucosa type of ectopic pancreas,7 cases were in the greater curvature of stomach and 2 in the bulb of the duodenum.Of the obstruction type,3 in the pyloric canal,2 in the periampullary and 3 in the jejunum including one case of intussusception.Of the ulcer type,2 in the stomach with central umbilication sign and 2 in the bulb of duodenum.Of diverticulum type,1 in the mastoid portion of duodenum,1 in the jejunum and 2 in the ileum adjacent to ileocecal junction.③ Their pathological findings showed 6 cases in typeⅠ,14 in type Ⅱ and 5 in type Ⅲ.11 out of 14 enhanced patients showed strong enhancement similar to the pancreas of typeⅠor typeⅡ pathological feature.3 cases showed poor enhancement with type Ⅲ pathological features.Conclusion: Ectopic pancreas of different parts in the alimentary tract show different characteristics.Different CT appearance patterns are correlated with their pathologic findings.CT examination is helpful to their correct diagnosis.