| 董力宁,张洁,杨大为,刘朋,徐辉,杨正汉,靳二虎.IgG4相关硬化性胆管炎随访中影像学表现与血清IgG4变化趋势的一致性[J].中国医学影像技术,2023,39(2):230~234 |
| IgG4相关硬化性胆管炎随访中影像学表现与血清IgG4变化趋势的一致性 |
| Consistency analysis of changing trend between imaging findings and serum IgG4 level in follow-up patients with IgG4-related sclerosing cholangitis |
| 投稿时间：2022-06-19 修订日期：2023-01-02 |
| DOI：10.13929/j.issn.1003-3289.2023.02.018 |
| 中文关键词: 胆管炎,硬化性 免疫球蛋白G4相关疾病 体层摄影术,X线计算机 磁共振成像 随访研究 |
| 英文关键词:cholangitis, sclerosing immunoglobulin G4-related disease tomography, X-ray computed magnetic resonance imaging follow-up studies |
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| 中文摘要: |
| 目的 观察IgG4相关硬化性胆管炎（IgG4-SC）随访影像学表现与血清IgG4水平变化的一致性。方法 对24例IgG4-SC患者进行影像学和临床随访，分析影像学所见与血清IgG4变化趋势的一致性。结果 24例均于激素治疗后接受持续2.9~45.7个月随访。治疗后1~2个月，首次影像学复查显示20例好转、4例进展；20例好转患者中，9例胆管扩张消失、11例仅轻度扩张，其中10例（10/15，66.67%）胆管壁厚度由（0.32±0.07） cm降至（0.23±0.03） cm （t=3.30，P=0.01）；4例进展患者中，2例MR胰胆管成像分型由Ⅰ型转变为Ⅱa型，之后分别转变为Ⅰ型、Ⅲ型，另2例胆管壁增厚加重；影像学改变与血清IgG4变化趋势具有中等一致性（Kappa=0.50，P=0.01）。治疗后4~6个月，针对15例的第2次随访结果显示影像学改变与血清IgG4变化趋势不一致（P>0.05）。结论 IgG4-SC经激素治疗后，胆管病变影像学转归与血清IgG4水平变化趋势不完全一致。 |
| 英文摘要: |
| Objective To explore the consistency of imaging findings of IgG4-related sclerosing cholangitis (IgG4-SC) patients after hormone therapy with the changing trend of serum IgG4 levels during follow-up. Methods The imaging and clinical follow-up of 24 patients with IgG4-SC were performed, and the consistency between the imaging findings and the changing trend of serum IgG4 was analyzed. Results All 24 patients underwent follow-up of 2.9 to 45.7 months. The imaging presences improved in 20 cases but progressed in 4 cases 1-2 months after hormone therapy. Among 20 improved cases, dilatation of bile ducts disappeared in 9 cases and relieved to mild degree in 11 cases, and the thickness of the involved bile duct wall decreased from (0.32±0.07)cm to (0.23±0.03)cm in 10 cases (10/15, 66.67%, t=3.30, P=0.01). Among 4 progressed cases, MR cholangiopancreatography (MRCP) showed that the type transformed from type Ⅰ to type Ⅱa in 2 cases, then to type Ⅰ and type Ⅲ of IgG4-SC,respectively, and the thickness of bile duct wall aggravated in the rest 2 cases. The changing trend of serum IgG4 was moderately consistent with that of imaging changes of the bile ducts in the first following-up of 24 cases (Kappa=0.50, P=0.01), but inconsistent in the second following-up of 15 cases 4-6 months after treatment (P>0.05). Conclusion Imaging findings and changing trend of serum IgG4 levels were not all consistent after hormone therapy of IgG4-SC. |
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