CT findings in autoimmune pancreatitis: assessment using multiphase contrast-enhanced multisection CT
CT findings in autoimmune pancreatitis: assessment using multiphase contrast-enhanced multisection CT
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DOI：
10.1016/j.crad.2010.06.002
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发表时间：
2010-09-01
影响因子：
2.6
通讯作者：
Naganawa, S.
中科院分区：
文献类型：
--
作者：
Suzuki, K.;Itoh, S.;Naganawa, S.
目的：探讨自身免疫性胰腺炎患者多期增强CT表现的特点。方法：回顾分析50例自身免疫性胰腺炎患者的CT表现，其中女性4例，男性46例，平均年龄65岁。这些患者至少有一个发现支持AIP的诊断：血清学异常、组织病理学异常或对类固醇的反应。结果：胰腺呈弥漫性增大16例(32%)，局灶性增大18例(36%)，无增大16例(32%)。49例(98%)胰腺实质异常增强，其中胰腺期低密度影45例(90%)，延迟期高密度影39例(87%)。胰腺也可见以下表现：包膜状边缘(n=24；48%)；主胰管管腔不显影(n=48；96%)；导管强化(n=26；52%)；主胰管上游扩张(n=27；54%)；胰腺实质上游萎缩(n=27；54%)；钙化(n=7；14%)；以及囊肿(n=5；10%)。42例(84%)患者有一种或多种胰外征象：胆管或胆总管异常(40例；80%)；胰腺周围(8例；16%)或主动脉旁(10例；20%)软组织增生；肾脏受累(15例；30%)。本研究重点介绍了皇家放射科学会AIR(C)2010年部分患者的胰管增强情况。爱思唯尔有限公司出版。保留所有权利。
AIM: To assess the spectrum of findings using multiphase contrast-enhanced computed tomography (CT) in patients with autoimmune pancreatitisMATERIALS AND METHODS: Fifty patients (four female and 46 male, mean age 65 years) were retrospectively identified from consecutive patients with abnormal CT findings of the pancreas and negative work-up for known causes. These patients had at least one finding supporting the diagnosis of AIP: serological abnormality, histopathological abnormality, or response to steroid. Two radiologists evaluated multiphase contrast-enhanced CT images in consensus.RESULTS: The pancreas showed diffuse enlargement (n = 16; 32%), focal enlargement (n = 18; 36%), or no enlargement (n = 16; 32%). Forty-nine (98%) patients showed abnormal contrast enhancement in the affected pancreatic parenchyma, including hypoattenuation during the pancreatic phase (n = 45; 90%) and hyperattenuation during the delayed phase (n = 39; 87%). The following findings were also seen in the pancreas: a capsule-like rim (n = 24; 48%); no visualization of the main pancreatic duct lumen (n = 48; 96%); ductal enhancement (n = 26; 52%); upstream dilatation of the main pancreatic duct (n = 27; 54%); upstream atrophy of the pancreatic parenchyma (n = 27; 54%); calcification (n = 7; 14%); and cysts (n = 5; 10%). Forty-two (84%) patients showed one or more of the following extrapancreatic findings: biliary duct or gallbladder abnormality (n = 40; 80%); peripancreatic (n = 8; 16%) or para-aortic (n = 10; 20%) soft-tissue proliferation; and renal involvement (n = 15; 30%).CONCLUSION: Patients with AIP presented with a variety of CT findings in the pancreas and the extrapancreatic organs. The present study highlights pancreatic ductal enhancement in a subset of patients with AIR (C) 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.