IgG4相关性胆管炎的CT及MRI影像学特征及鉴别诊断(1)
[摘要]目的 探討IgG4相关性胆管炎(IAC)的CT及MRI影像学特征及鉴别诊断情况。方法 选取2014年1月～2017年6月我院收治的获得明确诊断的15例IAC患者作为研究对象，对患者展开CT平扫和增强扫描、MRI平扫与增强扫描，并进行磁共振胰胆管造影(MRCP)检查，对检查结果进行统计学分析，检查结束后对患者实施激素治疗，通过电话、门诊对患者进行随访，并对影像学检查资料进行评价。结果 15例患者中，10例患者接受CT平扫联合增强扫描，8例患者接受MRI平扫联合增强扫描，10例患者接受MRCP检查。CT扫描显示，肝外胆管胰腺段管壁发生明显增厚，部分患者合并出现胰上段胆管壁偏心性增厚，胆管壁呈现出渐进性强化；MRCP检查显示，肝外胆管胰腺段狭窄，少数患者表现出肝内胆管狭窄、肝外胆管胰腺段狭窄。随访结果显示，8例患者未接受类固醇治疗，3例患者治疗后复发胆管病变，造成病情加重；其余患者在接受类固醇治疗后，胆管病变均发生明显好转。结论 IgG4相关性胆管炎患者的CT、MRI影像学检查存在明显特征，可为临床诊断和鉴别诊断提供可靠的参考依据，值得关注。
[关键词]IgG4相关性胆管炎；X线计算机断层成像；磁共振成像；诊断
[中图分类号] R575.7 [文献标识码] A [文章编号] 1674-4721(2018)1(c)-0076-03
CT and MRI imaging features and differential diagnosis of IgG4-associated cholangitis
LIUFU Yan-yu
Department of Imaging，Maoming Hospital of Traditional Chinese Medicine in Guangdong Province，Maoming 525000，China
[Abstract]Objective To investigate the CT and MRI imaging features and differential diagnosis of IgG4-associated cholangitis (IAC).Methods Altogether 15 patients who were confirmedly diagnosed as IAC in our hospital from January 2014 to June 2017 were selected as the subjects.The research was underwent CT plain scan and enhanced scan，MRI scan and enhanced scan as well as Magnetic Resonance Cholangiopancreatography (MRCP) examination.Statistical analysis of the examination results was made and all the patients received hormone therapy after examinations.Patients were followed up via telephone and outpatient.And the imaging data were evaluated.Results Of the 15 patients，10 patients received CT plain scan and enhanced scan，8 patients received MRI plain scan and enhanced scan，and 10 patients received MRCP examination.CT scan showed obvious thickening of the pancreatic duct wall of extrahepatic bile duct.Eccentric thickening of the bile duct wall in the upper part of the pancreas was also showed in some patients with progressive enhancement in bile duct wall.MRCP examination showed extrahepatic biliary pancreatic stricture，intrahepatic bile duct stricture and extrahepatic bile duct stricture were shown in a few patients.The follow-up results showed that 8 patients did not receive steroid treatment，and 3 patients had recurrent bile duct lesions after treatment，resulting in aggravation of the disease.In the rest of the patients，the lesions of the bile duct were obviously improved after steroid treatment.Conclusion The imaging features of CT and MRI in patients with IgG4-associated cholangitis have obvious characteristics，which can provide reliable references for clinical diagnosis and differential diagnosis，it deserves attention., http://www.100md.com(刘付 燕玉)
[关键词]IgG4相关性胆管炎；X线计算机断层成像；磁共振成像；诊断
[中图分类号] R575.7 [文献标识码] A [文章编号] 1674-4721(2018)1(c)-0076-03
CT and MRI imaging features and differential diagnosis of IgG4-associated cholangitis
LIUFU Yan-yu
Department of Imaging，Maoming Hospital of Traditional Chinese Medicine in Guangdong Province，Maoming 525000，China
[Abstract]Objective To investigate the CT and MRI imaging features and differential diagnosis of IgG4-associated cholangitis (IAC).Methods Altogether 15 patients who were confirmedly diagnosed as IAC in our hospital from January 2014 to June 2017 were selected as the subjects.The research was underwent CT plain scan and enhanced scan，MRI scan and enhanced scan as well as Magnetic Resonance Cholangiopancreatography (MRCP) examination.Statistical analysis of the examination results was made and all the patients received hormone therapy after examinations.Patients were followed up via telephone and outpatient.And the imaging data were evaluated.Results Of the 15 patients，10 patients received CT plain scan and enhanced scan，8 patients received MRI plain scan and enhanced scan，and 10 patients received MRCP examination.CT scan showed obvious thickening of the pancreatic duct wall of extrahepatic bile duct.Eccentric thickening of the bile duct wall in the upper part of the pancreas was also showed in some patients with progressive enhancement in bile duct wall.MRCP examination showed extrahepatic biliary pancreatic stricture，intrahepatic bile duct stricture and extrahepatic bile duct stricture were shown in a few patients.The follow-up results showed that 8 patients did not receive steroid treatment，and 3 patients had recurrent bile duct lesions after treatment，resulting in aggravation of the disease.In the rest of the patients，the lesions of the bile duct were obviously improved after steroid treatment.Conclusion The imaging features of CT and MRI in patients with IgG4-associated cholangitis have obvious characteristics，which can provide reliable references for clinical diagnosis and differential diagnosis，it deserves attention., http://www.100md.com(刘付 燕玉)