自身免疫性胰腺炎的MRI诊断价值

目的探讨自身免疫性胰腺炎（AIP）的MRI影像表现,提高对该病的认识和诊断水平。方法回顾性分析8例有MRI扫描资料的AIP病例,其中经手术病理证实5例,经临床综合指标及肾上腺皮质激素规范治疗随访证实3例。所有病例均行MRI平扫、动态增强扫描、MRI扩散加权成像（DWI）、磁共振胰胆管成像（MRCP）检查。结果 5例MRI表现为胰腺弥漫性肿大,局限肿块型2例,混合型（胰腺弥漫性肿胀伴胰头局限性肿块）1例;病灶周围＂包囊征＂6例,包囊完整或不完整;肾前筋膜增厚1例;动态增强扫描动脉期胰腺病灶、胰周＂包囊壁＂强化不明显,延迟扫描均呈渐进性强化;MRCP示胆管扩张、胰管节段性狭窄4例,另4例未见明显异常;激素治疗患者2~3次复查表现为胰腺病灶明显好转;所有病例DWI均显现胰腺病灶明显高信号。结论 AIP具有特征性的MRI影像表现,结合临床、实验室检查,大多数患者能够被明确诊断。

Dignostic value of MRI for autoimmune pancreatitis.

Objective To explore the manifestations of magnetic resonance imaging （MR） for autoimmune pancreatitis （AIP）. Methods The MRI data of 8 patients with AIP, in which 5 patients were confirmed by pathology and 3 by clinical data and treatment with adrenal cortex hormone, were analyzed retrospectively. Plain, post-contrast and diffusion-weighted MRI, as well as MRCP were performed in all patients. Results In MRI, 5 patients appeared diffuse swollen pancrease, 2 patients with local mass, 1 patient with diffuse swollen pancrease and local mass. Six pa- tients presented ＂pack sign＂ around lesions. One patient showed incrassate anterior renal fascia. Dynamic contrast showed no enhance in arterial phase and progressive enhance in delayed phase. Four patients showed dilated biliary duct and segmented stenotic pancreatic duct. All the patients presented obviously high signals in DWI. Follow-up ex- amination showed notable improvement in focus ofpancrease with treatment ofbormone. Conclusion AIP has some characteristic MRI features. Most cases of AIP can be diagnosed with MRI, combined with clinical and laboratory data.