自身免疫性胰腺炎的影像学诊断

缪飞; 陈芳莹

doi:10.3969/j.issn.1001-5256.2018.08.003

自身免疫性胰腺炎的影像学诊断

DOI: 10.3969/j.issn.1001-5256.2018.08.003

缪飞,
陈芳莹

上海交通大学医学院附属瑞金医院放射科

详细信息

中图分类号: R576
计量
- 文章访问数: 2248
- HTML全文浏览量: 34
- PDF下载量: 469
- 被引次数: 0
出版历程
- 收稿日期: 2018-04-20
- 出版日期: 2018-08-20

Imaging diagnosis of autoimmune pancreatitis

Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

摘要

摘要: 自身免疫性胰腺炎（AIP）是一种与自身免疫介导有关的特殊类型胰腺炎性疾病,临床上常表现为梗阻性黄疸,类固醇激素治疗效果好。目前AIP分为2种亚型,1型和2型。AIP典型影像学表现为胰胰弥漫性或局限性肿大,前者呈"腊肠征"改变。AIP的影像学检查方法各有优缺点,主要包括超声、经内镜逆行胰胆管造影、超声内镜、CT、MRI、PET-CT、PET-MR,均可有助于诊断及鉴别诊断,还可用于临床疗效的监测、随访。
- 胰腺炎 /
- 自身免疫疾病 /
- 超声检查 /
- 体层摄影术,X线计算机 /
- 磁共振成像 /
- 诊断
Abstract: Autoimmune pancreatitis ( AIP) is a special autoimmune-mediated pancreatitis with the clinical manifestation of obstructive jaundice, and it often has good response to steroids. At present, AIP is classified into type 1 and type 2. The imaging findings of AIP include diffuse or localized pancreatic parenchymal enlargement, and the former is also called the “sausage-shaped”appearance. Imaging examinations of AIP have their own advantages and disadvantages. Ultrasound, endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, computed tomography, magnetic resonance imaging, PET-CT, and PET-MR help with diagnosis and differential diagnosis and can be used for the monitoring and follow-up of clinical outcomes.
- pancreatitis /
- autoimmune disease /
- ultrasonography /
- tomography, X-ray computed /
- magnetic resonance imaging /
- diagnosis

HTML全文

参考文献(31)

[1]SARLES H, SARLES JC, MURATORE R, et al.Chronic inflammatory sclerosis of the pancreas-an autonomous pancreatic disease?[J].Am J Dig Dis, 1961, 6 (7) :688-698.

[2]YOSHIDA K, TOKI F, TAKEUCHI T, et al.Chronic pancreatitis caused by auto immune abnormality.Proposal of concept autoimmune pancreatitis[J].Dig Dis Sci, 1995, 40 (7) :1561-1568.

[3] SHIMOSEGAWA T, CHARI ST, FRULLONI L, et al.International consensus diagnostic criteria for autoimmune pancreatitis:Guidelines of the International Association of Pancreatology[J].Pancreas, 2011, 40 (3) :352-358.

[4]KAMISAWA T, CHARI ST, LERCH MM, et al.Recent advances in autoimmune pancreatitis:Type 1 and type 2[J].Gut, 2013, 62 (9) :1373-1380.

[5]HART PA, ZEN Y, CHARI ST.Recent advances in autoimmune pancreatitis[J].Gastroenterology, 2015, 149 (1) :39-51.

[6]KANNO A, MASAMUNE A, OKAZAKI K, et al.Nationwide epidemiological survey of autoimmune pancreatitis in Japan in 2011[J].Pancreas, 2015, 44 (4) :535-539.

[7] KAMISAWA T, CHARI ST, GIDAY SA, et al.Clinical profile of autoimmune pancreatitis and its histological subtypes:An international multicenter survey[J].Pancreas, 2011, 40 (6) :809-814.

[8]HART PA, KAMISAWA T, BRUGGE WR, et al.Long-term outcomes of autoimmune pancreatitis:A multicentre, international analysis[J].Gut, 2013, 62 (12) :1771-1776.

[9]WU L, LI W, HUANG X, et al.Clinical features and comprehensive diagnosis of autoimmune pancreatitis in China[J].Digestion, 2013, 88 (2) :128-134.

[10]KAWA S, HAMANO H, KIYOSAWA K.Autoimmune pancreatitis and Ig G4-related disease[M]∥The Autoimmune Diseases (Fifth Edition) , 2014:937-951.

[11]YIN QH, MIAO F.Imaging findings and features of autoimmune pancreatitis[J].Chin J Dig, 2017, 37 (5) :292-296. (in Chinese) 尹其华, 缪飞.自身免疫性胰腺炎影像学表现和特征[J].中华消化杂志, 2017, 37 (5) :292-296.

[12]NAITOH I, NAKAZAWA T, OHARA H, et al.Endoscopic transpapillary intraductal ultrasonography and biopsy in the diagnosis of Ig G4-related sclerosing cholangitis[J].J Gastroenterol, 2009, 44 (11) :1147-1155.

[13]KAWA S.Current concepts and diagnosis of Ig G4-related pancreatitis (type 1 AIP) [J].Semin Liver Dis, 2016, 36 (3) :257-273.

[14]UCHIDA K, MIYOSHI H, IKEURA T, et al.Clinical and pathophysiological issues associated with type 1 autoimmune pancreatitis[J].Clin J Gastroenterol, 2016, 9 (1) :7-12.

[15]RASCH S, PHILLIP V, SCHMID RM, et al.Epidemiology, clinical presentation, diagnosis and treatment of autoimmune pancreatitis:A retrospective analysis of 53 patients[J].Pancreatology, 2016, 16 (1) :73-77.

[16]RUNGE TM, HART PA, SASATOMI E, et al.Diagnosis of autoimmune pancreatitis using new, flexible EUS core biopsy needles:Report of 2 cases[J].Gastrointest Endosc, 2017, 85 (6) :1311-1312.

[17]LOPEZ-SERRANO A, CRESPO J, PASCUAL I, et al.Diagnosis, treatment and long-term outcomes of autoimmune pancreatitis in Spain based on the International Consensus Diagnostic Criteria:A multi-centre study[J].Pancreatology, 2016, 16 (3) :382-390.

[18] KANNO A, MASAMUNE A, FUJISHIMA F, et al.Diagnosis of autoimmune pancreatitis by EUS-guided FNA using a 22-gauge needle:A prospective multicenter study[J].Gastrointest Endosc, 2016, 84 (5) :797-804.e1.

[19]SCHEERS I, PALERMO JJ, FREEDMAN S, et al.Autoimmune pancreatitis in children:Characteristic features, diagnosis, and management[J].Am J Gastroenterol, 2017, 112 (10) :1604-1611.

[20] MIAO F.Imaging of pancreas[M].Beijing:People's Medical Publishing House, 2015:170-178. (in Chinese) 缪飞.胰腺影像学[M].北京:人民卫生出版社, 2015:170-178.

[21]SHI HY, ZHAO XS, YAN JY, et al.Diagnosis of autoimmune pancreatitis with computed tomography[J].Chin J Dig, 2017, 37 (5) :303-306. (in Chinese) 史红媛, 赵雪松, 严嘉仪, 等.自身免疫性胰腺炎的计算机断层扫描诊断[J].中华消化杂志, 2017, 37 (5) :303-306.

[22]LEE LK, SAHANI DV.Autoimmune pancreatitis in the context of Ig G4-related disease:Review of imaging findings[J].World J Gastroenterol, 2014, 20 (41) :15177-15189.

[23]XIN L, HE YX, ZHU XF, et al.Diagnosis and treatment of autoimmune pancreatitis:Experience with 100 patients[J].Hepatobiliary Pancreat Dis Int, 2014, 13 (6) :642-648.

[24]KAMISAWA T, TAKUMA K, ANJIKI H, et al.Differentiation of autoimmune pancreatitis from pancreatic cancer by diffusionweighted MRI[J].Am J Gastroenterol, 2010, 105 (8) :1870-1875.

[25]HUR BY, LEE JM, LEE JE, et al.Magnetic resonance imaging findings of the mass-forming type of autoimmune pancreatitis:Comparison with pancreatic adenocarcinoma[J].J Magn Reson Imaging, 2012, 36 (1) :188-197.

[26]CHOI SY, KIM SH, KANG TW, et al.Differentiating mass-forming autoimmune pancreatitis from pancreatic ductal adenocarcinoma on the basis of contrast-enhanced MRI and DWI findings[J].AJR Am J Roentgenol, 2016, 206 (2) :291.

[27]OKI H, HAYASHIDA Y, OKI H, et al.DWI findings of autoimmune pancreatitis:Comparison between symptomatic and asymptomatic patients[J].J Magn Reson Imaging, 2015, 41 (1) :125-131.

[28]KLAUβM, MAIER-HEIN K, TJADEN C, et al.IVIM DWMRI of autoimmune pancreatitis:Therapy monitoring and differentiation from pancreatic cancer[J].Eur Radiol, 2016, 26 (7) :2099-2106.

[29]LEE TY, KIM MH, PARK DH, et al.Utility of 18F-FDG PET/CT for differentiation of autoimmune pancreatitis with atypical pancreatic imaging findings from pancreatic cancer[J].AJR Am J Roentgenol, 2009, 193 (2) :343-348.

[30]CHEN X, WANG L, ZHANG L, et al.Ig G4-related autoimmune pancreatitis mimicking acute pancreatitis:A case report[J].Chin Med Sci J, 2017, 32 (1) :65-68.

[31]SUREKA B, BANSAL K.Autoimmune pancreatitis:Additional key imaging features[J].AJR Am J Roentgenol, 2016, 207 (1) :w4.

施引文献

资源附件(0)

访问统计