摘要
目的探讨沟槽区胰腺炎(groove pancreatitis,GP)的CT、MRI影像特征。方法回顾性分析2014年1月至2021年1月期间在我院诊治的胰腺炎病人资料,经过外科手术病理或内镜保守治疗后证实为GP患者18例。结果18例GP患者均行CT平扫及增强检查,其中5例另行MRI检查;18例GP患者在CT上均表现为胰头与十二指肠降段间占位,与十二指肠降部分界不清;5例行MRI检查的患者中,T_(1)WI序列上病灶均表现为低信号,T_(2)WI序列上,3例患者表现为高信号,2例表现为低信号。18例均有十二指肠降段肠壁不同程度增厚,其中8例合并有胆总管不同程度梗阻,4例合并有囊性灶,5例合并有胰头钙化灶,CT特征性表现为胰头和十二指肠之间新月形低密度灶,脂肪减少,十二指肠壁增厚伴管腔狭窄,沟槽炎性区呈渐进性延迟强化的表现。结论GP是一种少见的胰腺区域性慢性炎症,极易误诊为胰腺癌,影像学检查常具有较典型的表现,临床上多数GP患者有长期大量饮酒史,可引起黄疸,但一般呈波动性,CA19-9水平正常,本病特有的临床及影像表现对诊断及疗效评估具有重要的参考价值。
Objective To investigate the CT and MRI features of groove pancreatitis(GP).Methods Patients treated in our hospital and diagnosed with pancreatitis from January 2014 to January 2021 were retrospectively analyzed,18 patients were diagnosed with GP according to surgical pathology or endoscopic conservative treatment.Results 18 GP patients underwent CT plain and enhanced scan,5 of them underwent additional MRI examination.All 18 GP patients showed space occupying in different degrees in the pancreatic head and duodenal region on CT,with unclear boundary with the descending part of duodenum.5 cases of MRI examination showed low signal on T_(1)WI,3 cases showed high signal on T_(2)WI,and 2 cases showed low signal on T_(2)WI.All the 18 patients showed different degree of descending duodenal wall thickening.8 cases were complicated with common bile duct obstruction,4 cases with cystic lesions,and 5 case with calcification of pancreatic head.The typical CT signs were crescent low-density lesions between the head of pancreas and duodenum,fat reduction,duodenal wall thickening and lumen stenosis,and progressive delayed enhancement of the groove inflammatory area.Conclusion GP is a rare chronic inflammatory disease,which is very easy to be misdiagnosed as pancreatic cancer.CT and MRI images have typical image characteristics.In clinical practice,most GP patients have a long history of drinking,jaundice is fluctuating,and the level of CA19-9 is normal.Familiarity with its clinical and image characteristics can provide reference for accurate diagnosis.
作者
黄晓斌
付彤
张娣
彭明洋
武新英
王同兴
HUANG Xiao-bin;FU Tong;ZHANG Di;PENG Ming-yang;WU Xin-ying;Wang Tong-xing(Department of Radiology,Nanjing First Hospital,Nanjing Medical university,Nanjing 210006,Jiangsu Province,China)
出处
《中国CT和MRI杂志》
2024年第4期103-105,共3页
Chinese Journal of CT and MRI
关键词
沟槽区胰腺炎
影像特征
诊断
Groove Pancreatitis
Imaging Features
Diagnosis
