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目的探讨自身免疫性胰腺炎(autoimmune pancreatitis,AIP)的18氟-脱氧葡萄糖(18 F-fluorodeoxyglucose,18F-FDG)正电子发射断层扫描/计算机断层扫描(positron-emission tomography/computed tomography,PET/CT)的显像特征。方法回顾性分析14例经作者医院诊治的AIP患者的18F-FDG PET/CT资料,分析其胰腺局部及胰腺外器官的形态改变及代谢特征,并计算胰腺病变的平均滞留指数(retention index,RI),分析早期最大标准摄取值(maximum standardized uptake value,SUVmax)、延迟SUVmax之间的差异。结果 14例患者中,男5例,女9例,年龄31~67岁,平均年龄49岁。11例患者胰腺弥漫性肿大,3例患者胰腺头部增大,病变部位代谢活性均增高。10例患者的主胰管呈弥漫性狭窄,3例为局限性并多灶性狭窄,1例病变部位胰管局限性狭窄伴近端胰胆管扩张。5例患者出现胰腺周围鞘膜征;3例患者胰腺周围出现渗出。14例AIP患者胰腺早期SUVmax与延迟后SUVmax的差异有统计学意义(t=-6.63,P<0.05)。3例胰腺局灶性增大患者的早期SUVmax与延迟后SUVmax的差异无统计学意义(t=-4.5,P=0.05)。胰腺弥漫增大患者与胰腺局部肿大患者的早期SUVmax、延迟SUVmax、RI之间的差异无统计学意义(P>0.05)。14例AIP患者均出现胰腺外器官的改变;PET/CT的诊断正确率为71.4%(10/14),其中3例误诊为胰头癌,1例误诊为急性胰腺炎。结论 AIP的18F-FDG PET/CT显像有一定的特征性,了解其特征及其鉴别诊断特征,有助于提高该病的诊断正确率。
Objective To investigate the diagnostic value of 18 F-fluorodeoxyglucose (18F-FDG) positron-emission tomography / computed tomography (PET / CT) in autoimmune pancreatitis (AIP) ) Of the imaging features. Methods The 18F-FDG PET / CT data of 14 patients with AIP diagnosed and treated in our hospital were retrospectively analyzed. The morphological changes and metabolic characteristics of pancreatic and pancreatic organs were analyzed. The retention index (RI) of pancreatic lesions ), Analyzing the maximum standardized uptake value (SUVmax) and delaying the difference between SUVmax. Results 14 patients, 5 males and 9 females, aged 31 to 67 years, mean age 49 years. Eleven patients had diffuse enlargement of pancreas, three patients had enlarged pancreas and metabolic activity of lesion increased. Ten cases of pancreatic duct were diffuse stenosis, 3 cases were localized and multifocal stenosis, 1 case of localized pancreatic duct stricture with proximal pancreaticobiliary dilatation. Peripapillary sclerosis around the pancreas occurred in 5 patients; exudation occurred around the pancreas in 3 patients. The differences of early SUVmax and delayed SUVmax in 14 AIP patients were statistically significant (t = -6.63, P <0.05). There was no significant difference in early SUVmax and delayed SUVmax in 3 patients with focal pancreatic enlargement (t = -4.5, P = 0.05). There was no significant difference in early SUVmax, delayed SUVmax and RI between patients with enlarged pancreas and those with enlarged pancreas (P> 0.05). 14 cases of AIP patients showed changes in the external organs of the pancreas; PET / CT diagnostic accuracy was 71.4% (10/14), of which 3 were misdiagnosed as pancreatic head cancer, 1 case misdiagnosed as acute pancreatitis. Conclusions The 18F-FDG PET / CT imaging of AIP has certain characteristics, and its characteristics and differential diagnosis features are helpful to improve the diagnostic accuracy of this disease.