Acute interstitial edematous pancreatitis: Findings on non-enhanced MR imaging.
Acute interstitial edematous pancreatitis: Findings on non-enhanced MR imaging.
复制标题
急性间质性水肿性胰腺炎：非增强 MR 成像的结果。
DOI：
10.3748/wjg.v12.i36.5859
复制
发表时间：
2006
影响因子：
4.3
通讯作者：
Xiao
中科院分区：
文献类型：
--
作者：
Xiao;Z. Feng;Q. Zhao;Chun;D. Mitchell;J. Shu;Nan‐lin Zeng;Xiao;J. Lei;Xiao
目的
探讨急性间质水肿性胰腺炎（IEP）的MR平扫表现。
方法
对53例经临床和实验室检查确诊的IEP患者进行MRI检查。MR成像序列包括快速扰相梯度回波（FSPGR）脂肪饱和轴位T1加权成像、梯度回波T1加权（同相）、单次激发快速自旋回波（SSFSE）T2加权成像、呼吸触发（R-T）T2加权脂肪饱和成像和MR胰胆管造影。使用MR严重程度评分指数，将胰腺炎分级为轻度（0-2分）、中度（3-6分）和重度（7-10分）。
结果
在53名患者中，IEP在37名患者中被分级为轻度，在16名患者中被分级为中度。53例患者中有47例（89%）在MR图像上至少有一处异常。在FSPGR T1加权图像上，18.9%的患者胰腺相对于肝脏呈低信号，在SSFSE T2加权和R-T T2加权图像上分别有25%和30%的患者呈高信号。IEP在R-T T_2WI上的表现分别为胰腺筋膜平面85%、左肾筋膜平面77%、胰周脂肪绞窄55%、右肾筋膜平面42%、血管周围积液45%、胰腺小叶间隔增厚40%、胰周积液25%。与同时相或SSFSE T2加权像比较，差异有显著性（P<0.001）。
结论
IEP主要表现为胰腺筋膜平面、左肾筋膜平面增厚、胰周脂肪束和胰周积液。R-T T2加权成像比同相和SSFSE T2加权成像更敏感地显示IEP。
AIM
To study the appearances of acute interstitial edematous pancreatitis (IEP) on non-enhanced MR imaging.
METHODS
A total of 53 patients with IEP diagnosed by clinical features and laboratory findings were underwent MR imaging. MR imaging sequences included fast spoiled gradient echo (FSPGR) fat saturation axial T1-weighted imaging, gradient echo T1-weighted (in phase), single shot fast spin echo (SSFSE) T2-weighted, respiratory triggered (R-T) T2-weighted with fat saturation, and MR cholangiopancreatography. Using the MR severity score index, pancreatitis was graded as mild (0-2 points), moderate (3-6 points) and severe (7-10 points).
RESULTS
Among the 53 patients, IEP was graded as mild in 37 patients and as moderate in 16 patients. Forty-seven of 53 (89%) patients had at least one abnormality on MR images. Pancreas was hypointense relative to liver on FSPGR T1-weighted images in 18.9% of patients, and hyperintense in 25% and 30% on SSFSE T2-weighted and R-T T2-weighted images, respectively. The prevalences of the findings of IEP on R-T T2-weighted images were, respectively, 85% for pancreatic fascial plane, 77% for left renal fascial plane, 55% for peripancreatic fat stranding, 42% for right renal fascial plane, 45% for perivascular fluid, 40% for thickened pancreatic lobular septum and 25% for peripancreatic fluid, which were markedly higher than those on in-phase or SSFSE T2-weighted images (P<0.001).
CONCLUSION
IEP primarily manifests on non-enhanced MR images as thickened pancreatic fascial plane, left renal fascial plane, peripancreatic fat stranding, and peripancreatic fluid. R-T T2-weighted imaging is more sensitive than in-phase and SSFSE T2-weighted imaging for depicting IEP.