摘要
目的探讨自身免疫性胰腺炎（AIP）胰腺外病变的CT、MRI及18F-脱氧葡萄糖（FDG）PET—CT表现。方法回顾性分析2004年5月至2012年6月，符合2008年亚洲AIP诊断标准的44例患者的影像资料。检查包括增强CT扫描29例，MR扫描38例，18F—FDGPET—CT扫描6例，观察分析胰腺外病变的影像特征。结果（1）胆管受累32例，表现为胆管狭窄及管壁增厚强化，其中胆总管胰腺段狭窄，受累节段胆管壁增厚强化16例；肝门区胆管管壁增厚1例；胰腺段胆总管及其上游胆管均受累15例。（2）胆囊受累19例，表现为胆囊增大，壁增厚延迟强化；（3）肾脏受累10例，为双肾多发低灌注灶，T2WI上呈低信号；（4）血管受累16例，包括脾动（静）脉、肠系膜上动（静）脉和门静脉被包埋及静脉管径变细；（5）淋巴结改变35例，可见腹腔及腹膜后单组或多组淋巴结，其中多组15例，以腹腔淋巴结组最常见；（6）消化道受累2例，表现为胃及近段小肠浆膜面延迟强化；（7）腹膜后纤维化3例；（8）肝脏受累2例，表现为局灶性结节及肝内胆管周围片状异常强化；（9）颌下腺受累5例，PET-CT表现为颌下腺增大，放射性摄取增高。结论多器官受累是AIP的重要特征，了解其胰腺外病变表现有助于AIP的诊断。
Objective To describe the imaging findings of extrapancreatic lesions of autoimmune pancreatitis （AIP）. Methods From May ,2004 to June ,2012,44 patients were diagnosed of AIP according to Asia criteria of AIP made in 2008. All the imaging data, including contrast-enhanced CT （in 29 patients） or/and MR （in 38 patients）, and 18 F-FDG PET-CT （in 6 patients）, were retrospectively reviewed. All the extrapancreatic lesions was described involved in bile duct, gallbladder, kidneys, vessels, lymph nodes, liver, digestive tract, retroperitoneum, and salivary glands, etc. Results IgG4-related sclerosing cholangitis was revealed in 32 patients, presented biliary strictures and thickened wall of bile ducts. Among those, biliary lesions involved intrapancreatic segment of common bile duct （CBD） in 16 patients, hilar bile duct in 1 patient, both intrapancreatic and extrapancreatic segment of CBD in 15 patients, separately. Nineteen patients with AIP presented dilated gallbladder, with delayed enhancement of the thickened wall. Renal involvement was observed in 10, patients appeared as multiple round or wedge-shaped low-enhanced loci in bilateral renal parenchyma, which were hypo-intense on T2-weighted images with mild enhancement. Blood vessel involvement was observed in 16 patients, appeared as embedded vessels with or without stenosis. Furthernlore, abdominal lymphadenopathy was observed in 35 patients, in which celiac lymph node group was commonly found in addition to the involvement of multiple lymph node groups for 15 patients. Two patients presented delayed enhancement of serosa of stomach and proximal intestine. Three patients were diagnosed to have retroperitoneal fibrosis surrounding the aorta, inferior mesentary artery and superior mesentary artery. Focal nodular and abnormal enhancement of patchy lesion around intrahepatic bile duct implied of liver involvements in 2 patients. Five among six patients who took 18F-FDG PET-CT were observed salivary involvements with pathologic uptake of 18 F-FDG. Conclusion As multiple organs involvement wasthe critical characterization of AIP, sufficient understanding of relevant extrapancreatic diseases would be helpful to the diagnosis of this disease.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2013年第6期517-521,共5页
Chinese Journal of Radiology
基金
北京市自然科学基金资助项目（7102138）
