| 郑琴韵,黄欢,汪世存,潘博,展风麒,刘昕,倪明,杨易,丁有玲.多层螺旋CT应用于Ⅰ型肿块型自身免疫性胰腺炎诊断及评估激素治疗效果的价值[J].中国临床保健杂志,2019,22(1):108-110. |
| 多层螺旋CT应用于Ⅰ型肿块型自身免疫性胰腺炎诊断及评估激素治疗效果的价值 |
| Diagnostic value and therapeutic effect of MSCT on type Ⅰ autoimmune pancreatitis |
| 投稿时间：2018-01-08 |
| DOI：10.3969/J.issn.1672-6790.2019.01.029 |
| 中文关键词: 胰腺炎,自身免疫性 体层摄影术,X线 诊断,鉴别 |
| 英文关键词: Pancreatitis,autoimmune Tomography,X-ray Diagnosis,differential 〖FL |
| 基金项目:中央引导地方科技发展专项专业性技术创新平台项目(2017070503B041,YDZX20183400002555);安徽省重点实验室绩效项目(1606c08236) |
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| 中文摘要: |
| 目的 探讨分析多层螺旋CT(MSCT)三期动态增强扫描对肿块型自身免疫性胰腺炎(AIP)的诊断价值,及治疗前后疗效评估价值。方法 回顾性分析经病理证实或随访半年证实的24例肿块型AIP和24例胰腺癌(PC)患者的CT图像,比较两者在影像征象方面的差异,以及肿块型AIP激素冲击治疗后免疫球蛋白G4(IgG4)水平与影像学之间的变化关系,同时根据MSCT评分对疗效作出评估。结果 ①肿块型AIP组与PC组被膜样边缘改变:肿块型组AIP7例,PC组0例,χ2＝6.021,P＝0.014；周围血管侵犯:肿块型组AIP 4例,PC组19例,χ2＝16.362,P<0.001；周围淋巴结肿大:肿块型组AIP 3例,PC组10例,χ2＝5.169,P＝0.023；肾脏低密度:肿块型组AIP4例,PC组0例,χ2＝4.364,P＝0.037；胰管截断:肿块型组AIP 2例,PC组20例,χ2＝24.252,P＜0.001。胆总管增厚或变窄、肾上腺增粗、肝脏灌注不均及胰管的不规则扩张等,两组间差异无统计学意义(P＞0.05)。②MSCT评分与IgG4无相关性,但MSCT评分可以评估激素治疗效果。结论 MSCT三期扫描对肿块型AIP与胰腺癌的鉴别具有重要的临床意义,还可以用于评估激素对肿块型AIP的治疗效果。 |
| 英文摘要: |
| Objective To investigate the diagnostic value of multi-slice CT (MSCT) three-phase dynamic contrast-enhanced scanning in the diagnosis of autoimmune pancreatitis (AIP) and evaluate its curative effect before and after treatment.Methods The CT images of 24 cases of AIP and 24 cases of PC confirmed by histopathology or follow-up for 6 months were retrospectively analyzed.The envelopment-like edges,peripheral vascular invasion,dilatation or stenosis of pancreatic duct in the imaging signs were compared.Choledochal stenosis,lymph node enlargement and other organ involvement were compared between the differences;compared with the three enhance their substantive degree of enhancement is there any difference;after the comparison of the level of IgG4 tumor mass and imaging changes,At the same time according to the MSCT score to evaluate the efficacy.Results (1) There was a statistically significant difference between the AIP group and the PC group in the peripancreatic vascular invasion,peripheral lymphadenopathy,renal low density and pancreatic duct truncation(P＜0.05);the common bile duct thickening or narrowing,the adrenal gland (P>0.05).(2) There was no correlation between MSCT score and IgG4,but the effect of hormone therapy could be evaluated.Conclusion The three-phase MSCT scanning has important clinical significance for the diagnosis of pancreatitis and mass pancreatitis,especially for patients with AIP.It is also possible to evaluate the effect of hormones on the mass AIP. |
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