【摘要】 目的分析胰头部肿块型慢性胰腺炎(MFCP)与胰头癌的CT以及MRI定性及定量表现,总结二者有效的影像鉴别特点。方法选取我院16例胰头部MFCP及16例胰头癌临床及影像资料进行回顾性分析。结果胰头部MFCP与胰头癌影像表现:1)肿块形态密度:分叶状(2例,11例),假性囊肿(11例,0例),肿块内钙化(6例,0例);2)DWI高信号:(2例,14例);3)静脉期相对低密度(3例,15例);ROC曲线分析示静脉期CT差值鉴别二者的AUC=0.852;4)胰胆管表现:主胰管扩张(9例,12例),胰管病灶处截断(1例,10例),胆总管扩张(6例,12例),胆总管病灶处截断(2例,10例),双管征(7例,11例),不相交征(1例,12例),肝内胆管扩张(2例,11例);5)周围组织表现:肾周筋膜增厚(9例,3例),胰周血管包绕受侵(1例,2例)。结论胰头部MFCP与胰头癌的影像学表现具有特异性,肿块的形态、DWI信号、胰胆管扩张程度及二者的血供特点有助于二者诊断及鉴别诊断。更多还原

【Abstract】 Objective To analyze the qualitative and quantitative features of CT and MRI between mass-forming chronic pancreatitis(MFCP) and carcinoma of pancreatic head in order to obtain effective imaging features. Methods The data of 16 cases of pancreatic head MFCP and 16 cases of pancreatic head carcinoma in our hospital were analyzed retrospectively. Results The main imaging signs were followed respectively: 1)the shape and density of masses: lobulated(2 cases, 11 cases), pseudocysts(11 cases, 0 case), calcification within masses(6 cases, 0 case); 2) high signal in DWI(2 cases, 14 cases); 3) low density in venous phase relatively(3 cases, 15 cases). ROC curve analysis showed that venous phase’s CT value had better predictor for differential diagnosis with an area under the ROC curve(AUC) of 0.852; 4) performance of pancreatic and biliary duct: dilation of pancreatic duct:(9 cases, 12 cases), interupt of pancreatic ducts in lession’s area(1 case, 10 cases), dilation of bile duct(6 cases, 12 cases), interupt of bile ducts in lession’s area(2 cases, 10 cases), double duct sign(7 cases, 11 cases), no cross sign(1 case, 12 cases), intra-hepatic bile duct dilation(2 cases,11 cases); and 5) features of surrounding tissues: renal peritoneal fascia thickening(9 cases, 3 cases), blood vessels were embeded and invaded by masses(1 case, 2 cases). Conclusion The imaging findings of MFCP and carcinoma of pancreatic head are specific. The shape of the mass,the signal of DWI, the degree of dilatation of pancreaticobiliary duct and the characteristics of blood supply of both are helpful for the diagnosis and differential diagnosis.更多还原