CT and MRCP findings of autoimmune pancreatitis and small pancreatic carcinoma

( views:116, downloads:0 )
Author:
DING Jiu-le(Affiliated Third Hospital of Soochow University, Changzhou 213003, China)
XING Wei(Affiliated Third Hospital of Soochow University, Changzhou 213003, China)
ZUO Chang-jing()
YU Sheng-nan(Affiliated Third Hospital of Soochow University, Changzhou 213003, China)
QIU Jian-guo(Affiliated Third Hospital of Soochow University, Changzhou 213003, China)
SHENG Jing()
Journal Title:
Chinese Journal of Pancreatology
Issue:
Volume 12, Issue 02, 2012
DOI:
10.3760/cma.j.issn.1674-1935.2012.02.002
Key Word:
Autoimmune pancreatitis;Pancreatic neoplasm;Tomography;Tomography, X-ray computed;Magnetic resonance imaging

Abstract: Objective To increase the awareness of autoimmune pancreatitis (AIP) and correct diagnosis rate of AIP by investigating radiologic characteristic of AIP and small pancreatic cancers.Methods The clinical data and radiologic imaging of 24 AIP patients who met the Asia diagnostic criteria of AIP in 2008 and 25 cases of pathologically condirmed small pancreatic cancer were retrospectively reviewed.All imaging findings were reviewed,especially on the shape,enhancement patterns of mass,pancreatic ducts,peripancreatic and extra-pancreatic manifestations. Chi-square test and Fisher test were used for statistical analysis.Results The imaging signs,including location of masses,distal pancreatic atrophy,enhancing mass during portal phase,truncated duct sign of pancreatic duct,capsule-like rim and renal involvement,was significantly different between AIP and small pancreatic cancer ( x2 =9.010,10.506,15.488,8.688,6.292 and 4.966 respectively,P <0.05 ).But only two signs,distal pancreatic atrophy and enhancing mass during arterial and portal phase,were statistically different between local AIP and small pancreatic cancer (P <0.05).Conclusions The typical imaging features of diffuse AIP is distinct and helpful for the differential diagnosis of AIP from small pancreatic carcinoma,but there is limited value in the differential diagnosis between local AIP and small pancreatic cancer.

  • [1]尹秀玲,邱士军,张雪林.胰头部肿块型慢性胰腺炎与胰头癌的CT分析与鉴别.临床放射学杂志,2008,27:198-200.
  • [2]Abraham SC,Wilentz RE,Yeo CJ,et al. Pancreaticoduodenectomy (Whipple resections) in patients without malignancy:are they all ' chronic pancreatiC'? Am J Surg Pathol,2003,27:110-120.
  • [3]吕红,钱家鸣.自身免疫性胰腺炎不同诊断标准的探讨.胃肠病学,2009,14:4-7.
  • [4]Kamisawa T,Kim MH,Liao WC,et al.Clinical characteristics of 327 Asian patients with autoimmune pancreatitis based on Asian diagnostic criteria.Pancreas,2011,40:200-205.
  • [5]Horiuchi A,Kawa S,Hamano H,et al.ERCP features in 27 patients with autoimmune pancreatitis. Gastrointest Endosc,2002,53:494-499.
  • [6]Chang WI,Kim BJ,Lee JK,et al.The clinical and radiological characteristics of focal mass-forming autoimmune pancreatitis:comparison with chronic pancreatitis and pancreatic cancer.Pancreas,2009,38:401-408.
  • [7]马天顺,卢明智,邵成伟,等.胰腺癌的不典型64排螺旋CT影像表现.中华胰腺病杂志,2010,10:174-176.
  • [8]Shanbhogue AK,Fasih N,Surabhi VR,et al.A clinical and rsdiologic review of uncommon ty pes and causes of pancreatitis.Radiographics,2009,29:1003-1026.
  • [9]Manfredi R,Graziani R,Cicero C,et al. Autoimmune pancreatitis: CT patterns and their changes after steroid treatment.Radiology,2008,247:435-443.
  • [10]杨正汉,张骏,何淑蓉,等.自身免疫性胰腺炎的影像特征.中华放射学杂志,2007,41:47-50.
  • [11]Zhang L,Smyrk TC.Autoimmune pancreatitis and IgG4-related systemic diseases.Int J Clin Exp Pathol,2010,3:491-504.
  • [12]Law R,Bronner M,Vogt D,et al.Autoimmune pancreatitis:a mimic of pancreatic cancer.Cleve Clin J Med,2009,76:607-615.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn