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自身免疫性胰腺炎的临床及影像学表现分析

         

摘要

Objective To investigate the imaging characteristics of autoimmune pancreatitis (AIP)and its diagnostic value.Methods Imaging examinations and clinical data of 13 patients with AIP were reviewed retrospectively.Results Al patients had enlargement of pancreas either dif usely(n=11)or focal y in pancreatic head(n=2).The swol en pancreas was of homogeneous density on CT scan(n=13), hypo intese on T1-weighted images and mildly hyper intense on T2-weighted images in 4 patients.It was demonstrated as mild enhancement on artery phase of dynamic imaging and progressive enhancement on portal and delayed phase images.Capsule-like enhanced rim was presented around the pancreas in 9 patients.Stricture or obliteration of the common bile duct located in pancreatic head was found in 10 patients accompanied by intra hepatic bile duct dilation.Pancreatic duct was invisible on axial images in 11 cases.Among the 6 patients underwent MRCP,it was showed dif use and ir egular nar owing of the main pancreatic duct and stricture of common bile duct located in pancreatic head in 4 cases.ERCP showed dif use and ir egular nar owing of the main pancreatic duct in 7 cases.Extra-pancreatic lesion included veins around pancreas involvement in 8 cases;multiple low density renal lesions in 6 cases;retroperitoneal fibrosis in 2 cases;stricture of hilar duct,interstitial lung disease and ankylosing spondylitis in 1 case,respectively.Conclusion AIP shows some characteristic imaging features,and imaging examinations play an important role in the diagnosis of AIP. Recognition of extra-pancreatic lesions aids in the correct diagnosis of AIP.%目的:探讨自身免疫性胰腺炎的临床及CT、MRI表现。方法回顾性分析12例AIP患者的临床及影像学资料。结果12例患者实验室检查均有IgG4增高。8例表现为胰腺弥漫性肿大,呈"腊肠样",2例表现为体尾部局限性肿大,1例表现为胰头部局限性肿大。12例CT均表现为密度均匀减低,增强后强化减低,7例在MRI上表现为T1WI信号减低T2WI信号增高,增强后低强化。8例周围有假包膜样结构,6例合并肝内外胆管扩张。结论AIP影像学具有一定的特征性,影像学检查在AIP的诊断中起着重要的作用,结合临床特点有助于明确诊断,减少误诊。

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