摘要
目的观察自身免疫性胰腺炎(autoimmune pancreatitis,AIP)与胰腺癌(pancreatic cancer,PC)的CT影像特征,探讨CT在AIP与PC鉴别诊断中的价值。方法32例AIP患者(AIP组)和40例PC患者(PC组),均行CT平扫和增强扫描。比较2组CT影像中胰腺改变(胰腺弥漫性肿胀呈腊肠样改变、局灶性密度减低、胰周被膜样边缘、胰管改变)及胰腺外改变(胆管改变、血管受累和腹腔淋巴结肿大),CT增强扫描胰腺的密度均匀性;比较2组平扫及增强扫描动脉期、静脉期CT值。结果AIP组胰腺腊肠样弥漫肿胀、胰周被膜样边缘、胆管壁增厚及胆管渐进性狭窄比率(78.13%、59.38%、56.25%、75.00%)高于PC组(0、0、0、0)(P<0.05),胰腺局灶性密度减低、胰管截断、胆管截断、血管受累和腹腔淋巴结肿大比率(21.88%、3.13%、3.13%、25.00%、15.63%)低于PC组(100%、42.50%、30.00%、82.50%、87.50%)(P<0.05),胰管不规则扩张比率(43.75%)与PC组(52.50%)比较差异无统计学意义(P>0.05)。AIP组胰腺密度均匀、平扫期呈现偏低密度、静脉期呈现偏高密度比率(62.5%、100%、87.5%)高于PC组(0、22.5%、0)(P<0.05),胰腺密度不均、平扫期呈现明显低密度、静脉期呈现低密度比率(37.5%、0、12.5%)低于PC组(100%、77.5%、100%)(P<0.05);2组在动脉期均呈现低密度,差异无统计学意义(P>0.05)。AIP组平扫期、动脉期及静脉期的CT值[(39.34±4.32)、(74.63±10.01)、(92.74±10.16)Hu]均高于PC组[(26.03±9.05)、(52.68±12.60)、(57.93±13.27)Hu](P<0.05)。结论AIP与PC的CT影像特征存在差异,CT可辅助用于AIP与PC的鉴别诊断。
Objective To observe the CT imaging features of autoimmune pancreatitis(AIP)and pancreatic cancer(PC),and to investigate the value of CT to the differential diagnosis of AIP and PC.Methods Thirty-two patients with AIP(AIP group)and 40patients with PC(PC group)underwent plain and enhanced CT scans.The pancreatic changes(diffuse swelling of the pancreas with sausage-like changes,focal density reduction,peripancreatic capsule-like rim,pancreatic duct changes)and extraglandular changes(bile duct changes,vascular involvement and abdominal lymph node enlargement)were compared between two groups.The density uniformity of the pancreas was observed under enhanced CT scan.The CT values in arterial phase and venous phase were compared between two groups.Results The percentages of pancreaticoduodenal sausage-like diffuse swelling,peripancreatic capsule-like rim,bile duct wall thickening and progressive bile duct stenosis were higher in AIP group(78.13%,59.38%,56.25%,75.00%)than those in PC group(0,0,0,0)(P<0.05),while the percentages of pancreatic focal density decrease,pancreatic duct truncation,bile duct truncation,vascular involvement and abdominal lymph node enlargement were lower in AIP group(21.88%,3.13%,3.13%,25.00%,15.63%)than those in PC group(100%,42.50%,30.00%,82.50%,87.50%)(P<0.05).There was no significant difference in the percentage of irregular expansion of pancreatic duct between AIP group(43.75%)and PC group(52.50%)(P>0.05).The percentages of the pancreas with uniform density,low density in plain scan and slightly increased density in venous phase were higher in AIP group(62.5%,100%,87.5%)than those in PC group(0,22.5%,0)(P<0.05),while the percentages of uneven pancreatic density,obviously low density in plain scan and low density in venous phase were lower in AIP group(37.5%,0,12.5%)than those in PC group(100%,77.5%,100%)(P<0.05).Both groups showed low density in arterial phase,with no significant difference between two groups(P>0.05).The CT values of plain scan,in arterial phase and in venous phase were hi
作者
王东旭
杨俊
关雅迪
邴浩
南楠
曲素萱
林连捷
WANG Dongxu;YANG Jun;GUAN Yadi;BING Hao;NAN Nan;QU Suxuan;LIN Lianjie(Department of Gastroenterology,Shengjing Hospital of China Medical University,Shenyang 110134,China)
出处
《中华实用诊断与治疗杂志》
2020年第11期1161-1164,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
辽宁省自然科学基金(2014021083)
沈阳市科技计划项目(F15-199-1-39)。
关键词
自身免疫性胰腺炎
胰腺癌
CT
鉴别诊断
autoimmune pancreatitis
pancreatic cancer
CT
differential diagnosis
