赵维方

[摘要] 目的 分析自身免疫性胰腺炎的CT与MRI影像学特点。 方法 2015年7月—2018年2月于该院诊治的自身免疫性胰腺炎患者中方便选取56例，所有患者均得到确诊，对其影像学资料进行回顾性分析，22例患者行CT扫描，36例患者行MRI检查，30例同时行CT与MRI检查。 结果 56例患者中有36例患者得到确诊，16例患者被误诊，还有4例患者未得到明确诊断，确诊率较高的患者为胰腺局限性病变与弥漫性病变合并胰腺外表现的患者;胰腺外脏器与胰腺实质的信号改变情况、密度以及形态均能经CT与MRI清楚显示出来;胰腺实质胰腺弥漫性增大，且存在腊肠样表现。 结论 自身免疫性胰腺炎的CT与MRI影像均具有一定特征性，能为该疾病诊断与治疗提供科学合理的依据。

[关键词] 自身免疫性胰腺炎;CT;MRI;影像学特点;诊断;对比

[中图分类号] R445.2;R576;R816.5          [文献标识码] A          [文章编号] 1674-0742（2019）05（b）-0020-03

[Abstract] Objective To analyze the CT and MRI features of autoimmune pancreatitis. Methods From July 2015 to February 2018， 56 patients with autoimmune pancreatitis were convenient selected from our hospital. All patients were diagnosed. The imaging data were retrospectively analyzed. 22 patients underwent CT scan. 36 patients underwent MRI and 30 underwent CT and MRI. Results Of the 56 patients， 36 were diagnosed， 16 were misdiagnosed， and 4 were not diagnosed. Patients with a higher diagnosis rate were patients with localized pancreatic lesions and diffuse lesions with extra-pancreatic manifestations. The signal changes， density and morphology of pancreatic external organs and pancreatic parenchyma can be clearly revealed by CT and MRI; pancreatic parenchymal pancreas is diffusely enlarged， and there is a sausage-like appearance. Conclusion Both CT and MRI images of autoimmune pancreatitis have certain characteristics， which can provide a scientific and reasonable basis for the diagnosis and treatment of this disease.

[Key words] Autoimmune pancreatitis; CT; MRI; Imaging features; Diagnosis; Comparison

臨床上，慢性胰腺炎中，自身免疫性胰腺炎属于一种特殊类型，和患者自身免疫机制具有密切相关性[1]。自身免疫性胰腺炎可在全世界范围内发病，老年男性为其主要发病群体，将形态学作为依据，可将其分为局灶型与弥漫型[2]。该疾病严重危害了患者生命安全，为确保患者及时获得救治，改善其预后，需要及早对其做出明确诊断，并及时采取科学有效的措施对其进行治疗[3-4]。以往临床上因为对该疾病缺乏足够认识，所以通常会将其误诊为胰腺癌。近年来，我国影像技术水平明显提高，多数研究发现自身免疫性胰腺炎的CT与MRI表现存在明显特征性[5-6]。……