自身免疫性胰腺炎:20例患者的影像学结果

来源 :世界核心医学期刊文摘(胃肠病学分册) | 被引量 : 0次 | 上传用户:applexiao
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Abstract Abstract Background: Autoimmune pancreatitis is a new clinical entity that is characterized by peculiar histopathologic and laboratory findings and by a dramatic clinical response to corticosteroid therapy. We evaluated the radiologic findings of autoimmune pancreatitis. Methods: Computed tomographic, magnetic resonance imaging, endoscopic retrograde cholangiopancreatographic, and ultrasonographic findings of 20 patients with autoimmune pancreatitis in our hospital between November 2000 and December 2003 were retrospectively reviewed regarding changes and ancillary findings in the pancreatic parenchyma, the main pancreatic duct, peri-pancreatic vessels, and distal common bile duct. In addition, follow-up images were reviewed for changes in any abnormality seen on the initial examinations. Results: Pancreatic parenchymal enlargement was invariably seen that was diffuse (n = 19) or focal (n =1), with homogeneous contrast enhancement on computed tomography (n = 20) andmagnetic resonance imaging (n = 15). Capsule-like rim enhancement was seen in six patients. There was focal (n = 18) or diffuse (n = 2) narrowing of the main pancreatic duct and it was usually multifocal (n = 17) in the former. Narrowing of the peripancreatic veins was seen in 14 patients. There was tapered (n = 15) or abrupt (n = 3) narrowing of the distal common bile duct in 18 patients, with contrast enhancement of the narrowed segment in eight. Invariably, changes in the pancreatic parenchyma, main pancreatic duct, peripancreatic vessels, and common bile duct were normalized on follow-up studies after steroid therapy. Conclusion: In this series, common radiologic findings of autoimmune pancreatitis were (a) diffuse pancreas enlargement, (b) multifocal narrowing of the main pancreatic duct, (c) narrowing of peripancreatic veins, and (d) tapered narrowing of the distal common bile duct with frequent contrast enhancement. These findings were usually reversible with steroid therapy. Abstract Abstract Background: Autoimmune pancreatitis is a new clinical entity that is characterized by peculiar histopathologic and laboratory findings and by a dramatic clinical response to corticosteroid therapy. We evaluated the radiologic findings of autoimmune pancreatitis. Methods: Computed tomographic, magnetic resonance imaging, endoscopic retrograde cholangiopancreatographic, and ultrasonographic findings of 20 patients with autoimmune pancreatitis in our hospital between November 2000 and December 2003 were retrospectively reviewed regarding changes and ancillary findings in the pancreatic parenchyma, the main pancreatic duct, peri-pancreatic vessels, and distal common bile duct. In addition, follow-up images were reviewed for the changes in any abnormality seen on the initial examinations. Results: Pancreatic parenchymal enlargement was invariably seen that was diffuse (n = 19) or focal (n = 1), with homogeneous contrast enhancement on computed tomography (n = 20) and magnetic re There was focal (n = 18) or diffuse (n = 2) narrowing of the main pancreatic duct and it was usually multifocal (n = 17) Narrowing of the peripancreatic veins was seen in 14 patients. There was tapered (n = 15) or abrupt (n = 3) narrowing of the distal common bile duct in 18 patients, with contrast enhancement of the narrowed segment in eight . Invariably, changes in the pancreatic parenchyma, main pancreatic duct, peripancreatic vessels, and common bile duct were normalized on follow-up studies after steroid therapy. Conclusion: In this series, common radiologic findings of autoimmune pancreatitis were (a) diffuse pancreas enlargement , (b) multifocal narrowing of the main pancreatic duct, (c) narrowing of peripancreatic veins, and (d) tapered narrowing of the distal common bile duct with frequent contrast enhancement. These findings were usually reversible with steroid therapy.
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