IgG4相关硬化性胆管炎的CT和磁共振胰胆管成像表现

发布时间：2018-04-03 14:24

本文选题：体层摄影术　切入点：X线计算机　出处：《中国介入影像与治疗学》2015年06期

【摘要】：目的观察IgG4相关硬化性胆管炎(IgG4-SC)的CT和磁共振胰胆管造影(MRCP)影像表现。方法回顾性分析9例IgG4-SC患者的临床及影像资料,观察IgG4-SC初始病变的CT和MRCP特征及随访变化。结果初始病变:6例CT扫描显示肝外胆管胰腺段管壁增厚,其中2例伴有胰上段胆管壁偏心性增厚,增厚的胆管壁呈渐进性强化;7例MRCP检查中,6例显示肝外胆管胰腺段狭窄,1例肝内胆管狭窄和肝外胆管胰腺段狭窄,狭窄近侧的胆管呈中度至重度扩张。随访:5例未接受类固醇治疗以及2例治疗后复发的患者胆管病变均较初始加重。8例随访患者中,无论治疗及时与否,或是病变复发后再治疗,应用类固醇后胆管病变均显著好转。结论 IgG4-SC的CT和MRCP表现为胆管壁增厚、管腔狭窄和近侧胆管扩张,类固醇治疗后病变明显好转。
[Abstract]:Objective To observe the effect of IgG4 related sclerosing cholangitis (IgG4-SC) CT and magnetic resonance cholangiopancreatography (MRCP) imaging. Methods: a retrospective analysis of 9 cases of IgG4-SC patients with clinical and imaging data of CT and MRCP, observe the characteristics and follow-up of IgG4-SC initial lesions. Results: 6 cases of initial lesions CT scan showed extrahepatic bile duct of pancreas section of wall thickening, 2 cases with pancreatic duct upper eccentric thickening of bile duct wall thickening showed progressive enhancement; 7 cases MRCP examination, 6 cases showed extrahepatic bile duct pancreatic stricture, 1 cases of stricture of intrahepatic bile duct and extrahepatic bile duct of pancreatic section narrow, stenosis of proximal bile duct is moderate. To severe dilatation. Follow up: 5 patients received steroid therapy and 2 cases of recurrence after treatment of patients with bile duct lesions were compared with the initial exacerbation of.8 patients, whether treated in time or not, or recurrence after treatment, steroid after bile duct lesions were significantly Conclusion the CT and MRCP of IgG4-SC showed the thickening of the bile duct wall, the stenosis of the lumen and the dilatation of the proximal bile duct, and the lesions were obviously improved after steroid treatment.

【作者单位】：首都医科大学附属北京友谊医院放射科;首都医科大学附属北京中医医院放射科;首都医科大学附属北京友谊医院消化科;
【分类号】：R445.2;R575.7

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