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目的:观察自身免疫性胰腺炎(AIP)CT表现及动态变化特征。方法:回顾性分析6例AIP患者的临床及CT资料,通过随访患者分析类固醇治疗前、后不同时期AIP的CT表现及转归。结果:类固醇治疗前,5例AIP患者CT见胰腺弥漫性肿大,1例胰头局限性肿大;CT增强扫描显示受累胰腺渐进性强化;2例CT见胰周低密度带;6例受累胰腺区胰管不可见;6例CT见胰腺段胆管壁增厚、管腔狭窄。类固醇治疗后,6例复查和4例远期随访患者CT显示胰腺进行性缩小,其中2例萎缩的胰腺实质呈渐进性强化;2例胰周低密度带消失;6例胆管恢复至正常管径。3例胰腺病变复发,其中2例胰腺弥漫性肿大,1例胰头局限性肿大伴胰体尾萎缩;3例受累胰腺区胰管不可见;1例胰体尾前方出现假性囊肿。结论:类固醇治疗前与病变复发时AIP的CT表现相似,主要包括胰腺弥漫性、局限性肿大以及受累胰腺区胰管不可见,治疗后CT复查及随访可见胰腺进行性缩小或胰腺萎缩。
Objective: To observe the CT findings and dynamic changes of autoimmune pancreatitis (AIP). Methods: The clinical and CT data of 6 AIP patients were retrospectively analyzed. The CT findings and prognosis of AIP before and after steroid treatment were analyzed by follow-up. Results: Before steroid treatment, 5 patients with AIP had diffuse enlargement of pancreas and 1 enlarged pancreas of pancreas. CT enhanced scanning showed gradual enhancement of the affected pancreas, 2 cases of pancreatic weeks with low density of CT, 6 cases of involvement Pancreatic duct is not visible pancreas; 6 cases of CT see pancreatic thickening of the bile duct wall, stenosis. After steroid treatment, CT scan of 6 cases and 4 cases of long-term follow-up showed that the pancreas was progressively reduced. Two cases of atrophic pancreatic parenchyma were progressively enhanced; 2 cases of peripancreatic low density zone disappeared; and 6 cases of bile duct returned to normal diameter . Three cases of recurrent pancreatic lesions, including 2 cases of diffuse pancreas enlargement, pancreatic enlargement of the pancreas in 1 case with pancreatic body tail atrophy; 3 cases of pancreatic duct involvement pancreatic duct is not visible; 1 case of pancreatic tail in front of the pseudocyst. Conclusion: The CT findings of AIP before and after steroid treatment are similar, mainly including diffuse pancreas, limited enlargement and invisible pancreatic duct in the affected pancreas. CT scan and pancreas shrinkage or pancreas atrophy after CT examination and follow-up were observed.