摘要
目的总结自身免疫性胰腺炎(AIP)临床及超声影像分型特征。方法对2013年1月至2014年12月北京协和医院收治的28例AIP患者的临床及超声特征进行总结分析。结果 28例AIP患者临床表现:19例首发症状为梗阻性黄疸,14例伴发2型糖尿病,8例同时患有其他Ig G4相关性疾病。实验室检查:25例Ig G4水平升高,6例抗核抗体阳性。临床治疗:18例采用激素治疗,其中15例治疗后好转,3例治疗效果不显著。AIP超声影像表现:(1)弥漫型AIP 18例,16例胰腺弥漫性肿大,呈"腊肠样"改变,15例胰腺弥漫性回声减低,回声增粗,内部可见纤维化样高回声斑点。(2)局限型AIP 10例,胰腺局部肿大或呈肿物样低回声,回声与胰腺实质相近,其中6例形态不规则,7例边界不清,6例病变区内见少许血流,2例病变区内未见血流信号。(3)7例主胰管远端扩张,19例胆总管上段扩张,12例肝内胆管扩张。结论 AIP患者临床及超声影像表现有一定特点,患者年龄偏大、腹痛及梗阻性黄疸,超声影像显示胰腺弥漫性或局限性肿大,结合实验室检测结果有助于对AIP作出诊断。
Objective To investigate the clinical and sonographic features of automimune pancreatitis （AIP）. Methods We analyzed the clinical and sonographic features of 28 patients who were diagnosed as AIP in Peking Union Medical College Hospital from January 2013 to December 2014. Results Clinical features： the initial manifestation was obstructive jaundice in 19 cases. Fourteen cases were accompanied with type 2 diabetes. Eight cases were accompanied with IgG4-related diseases in other organs. Twenty-five cases had elevated IgG4 serum levels. Six cases had positive antinuclear antibodies. Eighteen cases had steroids therapy, 15 of whom had a good response to steroids, 3 of whom had a poor response. The ultrasonographic features were as follows： （1） Among 18 cases of diffuse type of AIP were as follows： 16 cases had a diffused, ＂sausage-like＂ enlarged pancreas. Fifteen cases had diffusely decreased echogenicity, with fibrous hyperechoic spots. （2） Ten cases of local type of AIP were as follows： the pancreas had local enlarged segment or a ＂tumor＂ was formed, but the echogenicity of tumor was similar to the rest of the pancreas. Six cases had irregular shape. （3） Seven cases had ill-defined margin. Six cases had a little blood flow. Two cases had no blood flow. Seven cases had upstream dilation of the main pancreatic duct. Nineteen cases had dilation of the proximal section of the common bile duct. Twelve cases had dilation of the intrahepatic bile duct. Conclusions AlP have some sonographic features. Patients are often older, having abdominal pain, obstructive jaundice, and diffused or local enlargement of pancreas. Combining with the clinical data and laboratory examination may help the diagnosis of AIP.
出处
《中华医学超声杂志（电子版）》
CSCD
2015年第5期396-401,共6页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
公益性行业基金(201402001)
关键词
超声检查
胰腺炎
自身免疫疾病
Ultrasonography
Pancreatitis
Automimune disease
作者简介
通讯作者：姜玉新，E-mail：jiangyuxinxh@163．com
