Can MRCP replace ERCP for the diagnosis of autoimmune pancreatitis?
Can MRCP replace ERCP for the diagnosis of autoimmune pancreatitis?
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DOI：
10.1007/s00261-008-9401-y
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发表时间：
2009-06-01
影响因子：
--
通讯作者：
Kamata, N.
中科院分区：
文献类型：
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作者：
Kamisawa, T.;Tu, Y.;Kamata, N.
自身免疫性胰腺炎（AIP）与胰腺癌的鉴别至关重要。主胰管不规则狭窄是 AIP 的特征性表现；它有助于区分 AIP 和胰腺癌狭窄。本研究评估了磁共振胰胆管造影（MRCP）诊断AIP的有用性，并评估MRCP是否可以替代内镜逆行胰胆管造影（ERCP）诊断AIP。比较了20例AIP患者的MRCP和ERCP表现。在MRCP上，主胰管的狭窄部分不可见，而胰管的非受累段可见。 AIP 患者近端主胰管上游扩张程度较胰腺癌患者轻。在跳过型中，仅跳过的狭窄病变未显现。对 AIP 进行类固醇治疗后，不可见的主胰管变得可见。MRCP 不能取代 ERCP 来诊断 AIP，因为 AIP 中的主胰管狭窄在 MRCP 上不可见。 MRCP 发现节段性或跳过的非可视化主胰管，伴有上游主胰管扩张较少，可能提示 AIP 的存在。 MRCP 对于以下 AIP 患者很有用。
It is of utmost importance that autoimmune pancreatitis (AIP) be differentiated from pancreatic cancer. Irregular narrowing of the main pancreatic duct is a characteristic finding in AIP; it is useful for differentiating AIP from pancreatic cancer stenosis. This study evaluated the usefulness of magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of AIP and assessed whether MRCP could replace endoscopic retrograde cholangiopancreatography (ERCP) for diagnosing AIP.The MRCP and ERCP findings of 20 AIP patients were compared.On MRCP, the narrowed portion of the main pancreatic duct was not visualized, while the noninvolved segments of the pancreatic duct were visualized. The degree of upstream dilatation of the proximal main pancreatic duct was milder in AIP than in pancreatic cancer patients. In the skipped type, only skipped narrowed lesions were not visualized. After steroid therapy for AIP, the nonvisualized main pancreatic duct became visualized.MRCP cannot replace ERCP for the diagnosis of AIP, since narrowing of the main pancreatic duct in AIP was not visualized on MRCP. MRCP findings of segmental or skipped nonvisualized main pancreatic duct accompanied by a less dilated upstream main pancreatic duct may suggest the presence of AIP. MRCP is useful for following AIP patients.