自身免疫性胰腺炎的CT和MRI的影像学表现

目的探讨自身免疫性胰腺炎CT和MRI的影像学特点,提高对自身免疫性胰腺炎的认识和影像学诊断水平。方法回顾性分析45例经激素治疗或手术病理证实的自身免疫性胰腺炎患者的CT和MRI影像学资料,观察胰腺及周围组织、胰管和胆管的影像学表现,总结自身免疫性胰腺炎CT和MRI的影像学特点。结果 45例自身免疫性胰腺炎患者中,男性32例,女性13例,其中37例患者表现为胰腺的弥漫性肿大,8例患者表现为胰腺局限性肿大,CT检查中有27例患者的胰腺病灶平扫密度减低;MRI检查中有16例患者胰腺病灶出现信号的改变,表现为T1WI上低信号,T2WI上稍高信号;45例患者胰腺病灶均表现为延迟强化方式改变。10例患者的CT和7例患者的MRI表现为胰管狭窄,2例患者的CT和1例的患者MRI表现为胆总管狭窄。14例患者的CT及MRI表现胰腺周围的"假包膜"征象。结论自身免疫性胰腺炎在CT和MRI上具有一定的影像学特点,结合实验室相关检查有助于该疾病的诊断。

The manifestations of computed tomography and magnetic resonance imaging on autoimmune pancreatitis

［Abstract］ Objective To investigate the imaging features of CT and MRI of autoimmune pancreatitis（AIP）and improve the preoperative diagnosis of the diseases. Methods CT and MRI imaging data of45 patients with AIP proved by effective clinical hormone therapy and surgery were retrospectively reviewed. Changes in pancreas and surrounding tissues, pancreatic duct and bile duct were analyzed. CT and MRI imaging features of AIP were summarized. Results Among the 45 patients with AIP, 32 were males, 13 were females. 37 patients were appeared pancreas diffusely enlargement, 8 patients with segmental enlargement, and the density of pancreatic lesions in all 27 patients was reduced during CT examination. In the 16 cases of MRI, signal changes were observed in pancreatic lesions, showing low signal on T1WI and slightly high signal on T2WI. Delayed enhancement was observed in all 45 patients. Pancreatic duct stenosis appeared in 10 cases of CT and 7 cases of MRI, and common bile duct stenosis appeared in 2 cases of CT and 1 case of MRI. In 14 cases, “pseudo capsule sign”was found in CT and MRI. Conclusion CT and MRI of AIP have certain characteristics. Combined with laboratory examination, the diagnosis of AIP is helpful.