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目的对比分析肿瘤相关性急性胰腺炎(tumorous acute pancreatitis,T-AP)与单纯性急性胰腺炎(non-tumorous acute pancreatitis,NT-AP)的影像学特征。方法回顾性分析2011年6月至2015年2月期间于四川大学华西医院手术及病理学检查证实的以急性胰腺炎为首发表现的胰腺肿瘤(16例)和单纯性急性胰腺炎(30例)患者的CT及MRI表现。结果 T-AP组表现为局限性结节或肿块16例(100%),NT-AP组0例;T-AP组主胰管最宽内径为(9.6±6.8)mm,扩张14例(87.5%),NT-AP组最宽内径为(2.9±0.9)mm,扩张7例(23.3%);T-AP组有区域性门静脉高压10例(62.5%),NT-AP组1例(3.4%);T-AP组合并胆石症3例(18.8%),NT-AP组25例(83.3%);T-AP组淋巴结显示14例(87.5%),NT-AP组30例(100%)。T-AP组的局限性结节或肿块发生率、主胰管扩张率及扩张程度、区域性门静脉高压以及合并胆石症发生率均明显高于NT-AP组,其差异均有统计学意义(P=0.000),而病灶强化方式与淋巴结显示率二组间比较差异无统计学意义(P>0.05)。结论 T-AP的影像学表现多样,CT及MRI的应用能为其提供可靠的诊断依据。
Objective To compare and analyze the imaging features of tumor-associated acute pancreatitis (T-AP) and non-tumorous acute pancreatitis (NT-AP). Methods A retrospective analysis of pancreatic tumors (16 cases) and simple acute pancreatitis (30 cases) with acute pancreatitis as the first manifestation confirmed by surgery and pathology in West China Hospital of Sichuan University from June 2011 to February 2015 was retrospectively analyzed. Patients with CT and MRI performance. Results T-AP group showed localized nodules or mass in 16 cases (100%) and NT-AP group (0 cases). The diameter of the main pancreatic duct in T-AP group was (9.6 ± 6.8) mm and expansion was in 14 cases %). The widest diameter of NT-AP group was (2.9 ± 0.9) mm and the expansion was 7 cases (23.3%). There were 10 cases of regional portal hypertension in T-AP group (87.8%) in the T-AP group and 30 (100%) cases in the NT-AP group ). In the T-AP group, the incidence of nodules or lumps, the rate of dilatation and expansion of the main pancreatic duct, regional portal hypertension and cholelithiasis were significantly higher than those in the NT-AP group (P < P = 0.000). However, there was no significant difference between the two groups in lesion enhancement and lymph node (P> 0.05). Conclusion The imaging findings of T-AP are diverse. The application of CT and MRI can provide a reliable basis for diagnosis.