急性胰腺炎伴胰管扩张MRCP表现及临床意义

目的 分析急性胰腺炎(AP)伴胰管扩张的MRCP表现及临床意义。 方法 分析确诊为AP的51例患者的临床和MRCP表现,比较胰管扩张AP病例(A组)与胰管正常AP病例(B组)的影像学表现差异。MRCP观察项目包括胰管和胆总管(CBD)直径、胰管形态、有无胰胆管结石及胰腺假性囊肿;临床观察项目包括病程及是否为复发(ARP)。 结果 A组21例AP 有胰管扩张 ,其中17例胰管边缘光滑,4例粗细不均;B组30例AP胰管正常 。A组3例伴假性囊肿,B组未见(P<0.05)。A、B两组CBD直径分别为 。A组11例、B组3例见双管征(P<0.01)。A组12例、B组仅6例ARP(P<0.01)。A组平均治疗天数为(24.43±10.63)天,B组为(15.03±5.45)天(P<0.001)。 结论 胰管扩张与非扩张AP的MRCP表现及临床病程存在一定差异,认识这些表现有助于做出正确影像学诊断和合理的临床评价。

MRCP manifestations and clinical significances of acute pancreatitis with pancreatic duct dilatation

Objective To investigate MRCP manifestations and clinical significances of acute pancreatitis (AP) with pancreatic duct dilatation. Methods A retrospective study was carried out in a series of 51 patients with AP. MRCP and clinical data were analyzed and compared between AP with or without pancreatic duct dilatation (group A and group B). Observation of MRCP included the diameter of pancreatic duct (PD) and common bile duct (CBD), the contour of PD, stones of PD and CBD, as well as pancreatic pseudocyst. The clinical observation included the course of AP, acute relapsing pancreatitis (ARP) or not, as well as the clinical severity of AP. Results There were 21 patients in group A (the diameter of PD was cm), the contour of PD was smooth in 17 patients and irregular in 4 patients. There were 30 patients in group B, in which the diameter of PD was (0.22±0.02) cm. Pancreatic pseudocyst was seen in 3 patients in group A, but none in group B (P<0.05). The diameter of CBD in group A and group B was (0.98±0.44)cm and (0.70±0.25)cm (P<0.01), respectively. Double duct sign was seen in 11 patients in group A, while only 3 in group B (P<0.01). ARP was identified 12 patients in group A and 6 patients in group B (P<0.01). The mean treatment time was (24.43±10.63) days in group A and (15.03±5.45) days in group B (P<0.001). Conclusion There are some differences of MRCP and clinical manifestations between AP with or without pancreatic duct dilatation, which could aid in making correct imaging diagnosis and reasonable clinical evaluation for patients with AP.