| 王佳妮,张洁,杨大为,刘朋,杨正汉,靳二虎.自身免疫性胰腺炎假包膜CT及MRI表现[J].中国医学影像技术,2021,37(9):1358~1362 |
| 自身免疫性胰腺炎假包膜CT及MRI表现 |
| CT and MRI manifestations of pseudocapsule of autoimmune pancreatitis |
| 投稿时间：2020-07-01 修订日期：2021-05-13 |
| DOI：10.13929/j.issn.1003-3289.2021.09.019 |
| 中文关键词: 自身免疫性胰腺炎 体层摄影术,X线计算机 磁共振成像 假包膜 |
| 英文关键词:autoimmune pancreatitis tomography, X-ray computed magnetic resonance imaging pseudocapsule |
| 基金项目: |
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| 中文摘要: |
| 目的 观察自身免疫性胰腺炎（AIP）假包膜的CT及MRI表现，并探讨其形成机制。方法 回顾性分析48例临床诊断AIP患者，观察胰周是否存在假包膜及其CT、MRI表现，并随访评估经类固醇激素治疗后假包膜变化。结果 48例AIP中，34例（34/48，70.83%）胰周存在假包膜。33例接受腹部CT检查，其中19例（19/33，57.58%）可见中位厚度为0.50 cm的假包膜，平扫呈等或稍低密度，增强扫描强化程度低于胰腺实质，动脉期明显强化（t=-3.970，P=0.003），静脉期强化更显著（t=-11.471，P<0.001）。35例接受腹部MR检查，其中27例（27/35，77.14%）胰周存在中位厚度为0.40 cm的假包膜，T1WI均呈低信号，T2WI 7例（7/27，25.93%）呈稍高信号、20例（20/27，74.07%）呈低信号，弥散加权成像信号均无明显增高，增强表现为延迟强化。21例接受2~34个月随访，中位随访时间18个月；3例随访2~3个月后假包膜变薄，18例随访10~12个月后假包膜完全消失。结论 AIP假包膜CT及MRI表现具有一定特征性，并可随胰腺炎症消散而完全吸收，提示其为慢性炎症伴纤维化过程。 |
| 英文摘要: |
| Objective To observe CT and MRI manifestations of pseudocapsule of autoimmune pancreatitis (AIP), and to discuss its formation mechanisms. Methods Data of 48 patients with clinically diagnosed AIP were retrospectively analyzed. The presence or not of pseudocapsule around the pancreas was observed, the relative CT and MRI manifestations were analyzed, and the changes after steroid therapy were followed up. Results Among 48 patients, 33 underwent abdominal CT and 35 underwent abdominal MR examination. Pseudocapsule around the pancreas was detected in 34 cases (34/48, 70.83%). CT showed 19 (19/33, 57.58%) cases had pseudocapsule with the median thickness of 0.50 cm, which present equal or slightly lower density on plain CT, and the enhancement degree was lower than that of pancreatic parenchyma on enhanced CT. The enhancement degree of pseudocapsule was obvious dring arterial phase (t=-3.970, P=0.003) but more significant during venous phase (t=-11.471, P<0.001). MRI depicted pseudocapsule with a median thickness of 0.40 cm in 27 cases (27/35, 77.14%), all showed hypointense on T1WI, while slightly hyperintense in 7 cases (7/27, 25.93%) and hypointense in 20 cases (20/27, 74.07%) on T2WI, not significant hyperintense on diffusion weighted imaging (DWI), and with delayed enhancement on enhanced MRI. Totally 21 patients received follow-up for 2-34 months, with the median follow-up of 18 months. Among them, the pseudocapsule became thinner in 3 cases after 2-3 months, while disappeared completely in 18 cases after 10-12 months. Conclusion CT and MRI manifestations of AIP pseudocapsule had certain characteristics. The pseudocapsule could completely disappear with the dissipation of pancreatitis, suggesting that its formation might be a chronic inflammatory process with fibrosis. |
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