Evaluation of magnetic resonance imaging in autoimmune pancreatitis before and after treatment
10.3760/cma.j.issn.2095-2848.2018.04.006
- VernacularTitle:自身免疫性胰腺炎治疗前后的磁共振评价
- Author:
Yuexi CHEN
1
;
Weike ZENG
Author Information
1. 510620,广州市第十二人民医院放射科
- Keywords:
Pancreatitis,chronic;
Autoimmune disease;
Magnetic resonance imaging;
Treatment outcome
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2018;38(4):252-256
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the imaging features of MRI in autoimmune pancreatitis (AIP) and analyze the diagnostic value before and after treatment.Methods MRI data of 20 AIP patients (14 males,6 females;average age:(54.0±10.3) years) from January 2013 to December 2015 were retrospectively analyzed.The sequences of MRI included T1 weighted imaging (WI),T2WI,MR cholangiopancreatography (MRCP),diffusion weighted imaging (DWI) and dynamic enhancement images.Fifteen of the patients received DWI again after hormone therapy.The location and extent of lesions,signal,patterns of dynamic enhancement,"pseudocapsule" sign and other accompanying signs,the apparent diffusion coefficient (ADC) of the lesion and the DWI manifestations before and after treatment were observed,calculated and compared.x2 test and paired t test were used to analyze the data.Results Five patients were confirmed by pathology and 15 by clinical follow-up.In MRI,16 patients appeared diffusive swollen pancreases,and 4 patients were with focal enlargement.Lesions of pancreas showed low signal on T1WI and high signal on T2WI.Twelve patients presented "pseudocapsule" around the lesions and progressive enhance was shown in the delayed phase on dynamic contrast enhanced MRI.Ten patients showed stenotic choledoch in the head of pancreas and segmented stenotic pancreatic duct in MRCP.All pancreatic lesions in the 10 patients presented high signals on DWI.The pancreatic morphology,the signal of the lesion,the "pseudocapsule" sign and the enhancement degree on MRI were significantly improved compared with those before treatment in 15 patients (x2 values:5.000-22.941,all P＜0.05).Mter hormone therapy,the signals on DWI were markedly weakened in pancreatic parenchyma,and ADC was significantly higher than that before treatment ((1.27± 0.14)×10-3 vs (1.05±0.16)×10-3 mm2/s;t=4.15,P＜0.01).Conclusion DWI could reflect the pathological and biological characteristics of AIP and be used to evaluate the therapeutic efficacy of hormone treatment in AIP.
