慢性胰腺炎及并发症.ppt

MRI of Pancreatitis and Its Complications: Chronic Pancreatitis; Chronic pancreatitis is an inflammatory disease characterized by progressive and irreversible structural damage to the pancreas resulting in permanent impairment of both exocrine and endocrine functions. ERCP is the gold standard for early chronic pancreatitis, but it is invasive. MRI may be an alternative for patients in whom CT or ERCP is contraindicated or not tolerated.MRI provides noninvasive biliary and pancreatic duct imaging and accurate characterization of pancreatic and peripancreatic pathology.慢性胰腺炎是一种炎症性疾病，其特征是对胰腺逐步和不可逆转的结构性损坏，导致外分泌和内分泌功能的永久性受损。 ERCP是诊断早期慢性胰腺炎的金标准，但它是侵入性检查。 在CT或ERCP为禁忌或不能耐受时，MRI可作为替代。MRI提供非侵入性胆胰管成像和胰腺及胰周病变的征象。 ;The diagnosis of chronic pancreatitis on MRI is based on signal intensity and enhancement changes as well as on morphologic abnormalities in the pancreatic parenchyma, pancreatic duct, and biliary tract. The imaging features of chronic pancreatitis can be divided into early and late findings. ;Early findings include low-signal-intensity pancreas on T1-weighted fat-suppressed images, decreased and delayed enhancement after IV contrast administration, and dilated side branches. Late findings include parenchymal atrophy or enlargement, pseudocysts, and dilatation and beading of the pancreatic duct often with intraductal calcifications.;MRI allows early recognition of chronic pancreatitis based on changes in pancreatic signal intensity; these changes are best visualized on unenhanced and gadolinium-enhanced T1-weighted fat-suppressed images (Fig. 1A, 1B, 1C, 1D). ;Fig.1A. 1B.;Axial enhanced T1-weighted fat-suppressed spoiled gradient-echo image obtained during arterial phase shows delayed enhancement of pancreatic tail (arrow) relative to normal pancreas due to fibrosis. Patient later developed atrophic changes in this area that led to resection of pancreatic tail.Contrast-enhanced CT scan shows punctate high-density focus (arrow) in pancreatic duct representing sma