十二指肠异位胰腺的临床特点及影像学误诊分析

发布时间：2018-04-18 22:16

  本文选题：胰腺疾病 + 十二指肠疾病　； 参考：《中国临床医学影像杂志》2017年07期

【摘要】：目的:探讨十二指肠异位胰腺的临床特点和CT表现。方法:回顾性分析影像学误诊但经病理证实的10例十二指肠异位胰腺患者的临床及影像资料,分析患者的主要临床表现、病变部位、病变形态特征、长径(LD)与短径(SD)比值范围,以及病灶与正常胰腺组织CT值的差异性。结果:主要临床表现:反复腹痛伴腹胀5例,黑便3例,黄疸2例;影像学表现:2例病灶未见显影,分别位于十二指肠乳头部和Vater壶腹;8例可见病灶均表现为位于Vater壶腹以上的结节性病灶,其中6例基底部呈山田Ⅱ型,7例腔内生长,5例密度均匀且边界清晰;8例可见病灶LD/SD值:1.14~1.92,平均1.52±0.24,5例LD/SD1.4;病灶实质区平扫及静脉期CT值稍低于同层正常胰腺组织(t=-3.41,-1.00,P0.05),差值均数仅分别为(6.38±2.45)HU、(5.25±3.33)HU,肉眼观难以分辨;误诊情况:4例误诊为平滑肌瘤或炎性息肉,4例误诊为间质瘤;2例误诊为壶腹周围癌。结论:十二指肠异位胰腺影像学多表现为宽基底、腔内生长、边界清晰、密度均匀、强化方式及程度与正常胰腺基本一致的结节,但当病灶表现不典型(如边界不清、密度不均、未见显影)时易造成误诊。临床工作中加强对本病的认识,充分结合临床表现,有助于做出提示性诊断。
[Abstract]:Objective: to investigate the clinical features and CT findings of duodenal ectopic pancreas.Methods: the clinical and imaging data of 10 patients with duodenal ectopic pancreas who were misdiagnosed by imaging and proved by pathology were retrospectively analyzed. The main clinical manifestations, pathological location, pathological morphology and the ratio of LDD to SD1 were analyzed.And the difference of CT value between the lesion and normal pancreatic tissue.Results: the main clinical manifestations were repeated abdominal pain with abdominal distension in 5 cases, black stool in 3 cases, jaundice in 2 cases, and no imaging findings in 2 cases.The lesions in the duodenal head of the mammary gland and in the ampulla of Vater were all nodular lesions located above the ampulla of Vater.Of them, 6 cases showed Yamada 鈪，

本文编号：1770314