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目的探讨急性胰腺炎(AP)并发各类胰周血管疾病的MRI表现。资料与方法回顾性分析本院2009年6月至2010年9月期间122例AP患者资料,男73例,女49例,平均年龄(45±16)岁。所有病例均签署知情同意书。采用GE1.5TMR扫描:梯度回波T1加权,快速恢复快速自旋回波T2加权,单次激发快速自旋回波T2加权,MR胰胆管成像,动态增强扫描。观察:(1)动脉侵犯/动脉炎;(2)假性动脉瘤;(3)静脉炎、静脉血栓形成/静脉栓塞;(4)胰源性门静脉高压症/门静脉海绵样变。结果本组AP并发胰周血管病变的发生率为17.2%(21/122)。21例AP并发胰周血管病变患者中,动脉侵犯/动脉炎占16/21(脾动脉、肝总动脉、肠系膜上动脉、腹腔干受累率分别为16/16、13/16、12/16、7/16)。脾动脉假性动脉瘤占1/21。静脉炎占19/21(脾静脉、门静脉、肠系膜上静脉受累率分别为19/19、13/19、9/19),静脉血栓形成/静脉栓塞占2/21(1例脾静脉部分性栓塞,另1例门静脉、脾静脉、肠系膜上静脉广泛性栓塞)。胰源性门静脉高压症/门静脉海绵样变占2/21。结论 AP能并发多种胰周血管病变,每种血管病变都有较特异的MRI表现。
Objective To investigate the MRI findings of all kinds of peripancreatic vascular diseases in acute pancreatitis (AP). Materials and Methods Retrospective analysis of 122 patients with AP in our hospital from June 2009 to September 2010, including 73 males and 49 females, with an average age of (45 ± 16) years. Informed consent was signed in all cases. Using GE1.5TMR scan: gradient echo T1 weighted fast recovery fast spin echo T2 weighted single shot rapid spin echo T2 weighted MR cholangiopancreatography dynamic enhanced scan. Observation: (1) arterial invasion / arteritis; (2) pseudoaneurysm; (3) phlebitis, venous thrombosis / vein embolism; (4) pancreatic portal hypertension / portal cavernous transformation. Results The incidence of peripancreatic vascular complications in this group was 17.2% (21/122). Of the 21 AP patients with peripancreatic vascular lesions, arterial invasion / arteritis accounted for 16/21 (splenic artery, common hepatic artery, superior mesenteric artery, celiac involvement rates were 16/16, 13/16, 12/16, 7/16). Splenic artery pseudoaneurysms account for 1/21. Phlebitis accounted for 19/21 (splenic vein, portal vein, superior mesenteric vein involvement rates were 19/19, 13/19, 9/19), venous thrombosis / venous thrombosis accounted for 2/21 (1 splenic vein partial embolism , Another 1 cases of portal vein, splenic vein, superior mesenteric vein embolization). Pancreatic portal hypertension / portal cavernous change accounted for 2/21. Conclusion AP can be complicated by a variety of peripancreatic vascular lesions, and each vascular lesion has a more specific MRI findings.