目的 探討胰腺脂肪替代(fatty replacement of pancreas)的CT表現及臨床意義。方法 收集CT發現胰腺脂肪替代患者3例的資料。CT掃描包括平掃、動脈期及門靜脈期,觀察胰腺各部的形態、大小、密度、胰腺小葉及小葉間隔、胰管走行的顯示情況,確定脂肪替代的部位,并結合臨床資料及實驗室檢查結果分析其臨床意義。結果 ①CT表現: 完全性脂肪替代2例(胰頭前后分、頸、體、尾),大部分脂肪替代1例(胰頭前分、頸、體); 2例胰腺形態均規整,1例欠規整; 2例胰腺體積稍大,1例胰腺體積正常; 3例小葉間隔均增寬及胰腺小葉均萎縮; 3例主胰管及分支均無狹窄梗阻。②臨床情況: 3例患者均有慢性腹瀉,2例合并糖尿病(其中1例還合并膽總管炎伴慢性梗阻),另1例合并膽總管小結石,3例血清脂肪酶及1例血清淀粉酶降低。結論 胰腺脂肪替代的CT表現有一定的特征性,常合并有胰腺內、外分泌功能不足的臨床表現。
引用本文:
李迎春,宋彬,徐雋,楊洋,印隆林. 胰腺脂肪替代的CT表現及臨床意義(附3例報告). 中國普外基礎與臨床雜志, 2006, 13(6): 724-728. doi:
復制
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- 1. Carucci LR, Jacobs JE. Focal fatty sparing of the pancreatic head in cystic fibrosis: CT findings [J].Abdom Imaging, 2003; 28(6)∶853.
- 2. 武忠弼, 楊光華主編. 中華外科病理學 [M]. 上卷. 第1版. 北京: 人民衛生出版社, 2002∶ 942~943.
- 3. Soyer P, Spelle L, Pelage JP, et al. Cystic fibrosis in adolescents and adults: fatty replacement of the pancreas——CT evaluation and functional correlation [J]. Radiology, 1999; 210(3)∶611.
- 4. Willi UV, Reddish JM, Teele RL. Cystic fibrosis: its characteristic appearance on abdominal sonography [J]. AJR Am J Roentgenol, 1980; 134(5)∶ 1005.
- 5. Tham RT, Heyerman HG, Falke TH, et al. Cystic fibrosis: MR imaging of the pancreas [J]. Radiology, 1991; 179(1)∶ 183.
- 6. Daneman A, Gaskin K, Martin DJ, et al. Pancreatic changes in cystic fibrosis: CT and sonographic appearances [J]. AJR Am J Roentgenol, 1983; 141(4)∶ 653.
- 7. Heuck A, Maubach PA, Reiser M, et al. Age-related morphology of the normal pancreas on computed tomography [J]. Gastrointest Radiol, 1987; 12(1)∶ 18.
- 8. Patel S, Bellon EM, Haaga J, et al. Fat replacement of the exocrine pancreas [J]. AJR Am J Roentgenol, 1980; 135(4)∶ 843.
- 9. Matsumoto S, Mori H, Miyake H, et al. Uneven fatty replacement of the pancreas: evaluation with CT [J]. Radiology, 1995; 194(2)∶ 453.
- 10. Li Y, Cao L, Wang BZ, et al. The structural change of pancreatic tissue of fatty rats induced with high-fat food and its pathological significance [J]. Chin J Histochem Cytochem, 2004; 13(3)∶ 353.
- 11. Katz DS, Nardi PM, Hines J, et al. Lipomas of the pancreas [J]. AJR Am J Roentgenol, 1998; 170(6)∶1485.