摘要
目的探讨胰头部肿块型慢性胰腺炎(MFCP)的多模态影像学特点。方法回顾性分析经手术病理证实的23例MFCP患者的影像资料,并与临床资料及病理结果进行对比分析,总结MFCP的影像学特征。所有病例均行多排螺旋CT平扫与多期CT增强检查,同时5例行MRI平扫与MRCP检查,17例行PET/CT检查。结果23例中17例CT诊断为MFCP,诊断符合率73.91%,6例(26.09%)被误诊为恶性占位/胰腺癌。MFCP直接征象的病灶平均直径、强化净增CT值、病灶DWI信号、ADC值、早期SUV值及晚期SUV值、肿块分叶征、肿块内钙化(混合型钙)、坏死囊变、假性囊肿均有统计学意义(P<0.05);MFCP间接征象的胆总管特征(“鼠尾状”狭窄、“胆胰管穿通征”)、胆管扩张、胰管扩张(串珠样扩张、均匀性扩张)伴有胰管结石、“胆胰管不相交征”、右侧肾周筋膜不均匀增厚、胰腺周围渗出明显亦均有统计学意义(P<0.05)。结论胰头部MFCP的多模态影像学表现具有一定的特征。
Objective To investigate the features of multi-modality imaging of the mass-forming chronic pancreatitis of the pancreatic head(MFCP)in order to improve the early precise diagnosis of this challenging condition in clinic.Methods The data of clinic and images(including CT,MRI and PET/CT)of 23 cases with MFCP confirmed by surgery and pathology between were analyzed retrospectively.All cases underwent multidetector computed tomography(MDCT)scan,including multiphase dynaimc contrast-enhanced CT scan(n=23),abdominal plain film(n=12),MRI(n=5)and PET/CT(n=17).The images were reviewed independently by two expert radiologists with double-blind method.Results In 23 cases of MFCP,17cases(73.91%)were correctly diagnosed and 6 cases(26.09%)were misdiagnosed as pancreatic carcinoma or malignant tumor with CT examination.The direct sign of MFCP,the mean diameter,enhanced net increase CT value,lesion DWI hyperintensity,ADC value,SUVmax values(SUV of lesion at early and delay phase),lobular sign,calcification(mixed calcification),necrosis cyst and pseudocyst were all statistically significant(P<0.05).The indirect sign of MFCP,Common bile duct characteristic("rat caudate narrow","bile pancreatic duct through"),bile duct expansion,expansion of the main pancreatic duct(beaded expansion,expansion uniformity),"bile pancreatic duct disjoint",thickening of the right renal fascia,significant exudation around lesion obviously also had statistical significance(P<0.05).Conclusion Multi-modality imaging with certain image characteristics is of significant clinical value in the early diagnosis and differential diagnosis of MFCP.
作者
瞿金环
阮志兵
卜碧玉
谢芹芹
QU Jinhuan;RUAN Zhibing;Bu Biyu;XIE Qinqin(Guizhou Medical University,Guiyang 550004,P.R.China;Department of Radiology,Xingyi People's Hospital,Xingyi 562400,P.R.China;Department of Imaging,Affiliated hospital of Guizhou Medical University,Guiyang 550004,P.R.China)
出处
《医学影像学杂志》
2020年第9期1657-1660,共4页
Journal of Medical Imaging
基金
贵州省科技厅基金项目〔编号:黔科合平台人才(2018)5779-72〕。
关键词
胰头病变
肿块型慢性胰腺炎
多模态影像学
影像特征
鉴别诊断
Pancreatic head disease
The mass-forming chronic pancreatitis
Multi-modality imaging
Imaging features
Differential diagnosis
