Imaging features of autoimmune pancreatitis / 中国医学科学院学报
Acta Academiae Medicinae Sinicae
;
(6): 479-484, 2008.
Article
in Chinese
| WPRIM
| ID: wpr-270665
ABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical, pathological, and imaging features of autoimmune pancreatitis (AlP).</p><p><b>METHODS</b>The clinical data of 10 patients (all men; aged 47-80 years, mean 61.3 years) with AlP in our hospital between March 2000 and August 2007 were retrospectively analyzed. gamma-globulin, immunoglobulin C (IgG), rheumatoid factors, and autoantibodies were examined for all cases. The imaging findings were reviewed, which included helical computed tomography (CT), endoscopic ultrasonography (EUS), and B-mode ultrasound in all patients, magnetic resonance cholangiopancreatography (MRCP) in 9 patients, and endoscopic retrograde cholangiopancreatography (ERCP) in 7 patients. Follow-up imaging results were available in 5 patients.</p><p><b>RESULTS</b>Clinically, the most common early symptoms included obstructive jaundice (9/10) and non-specific abdominal pain (1/10), accompanied by the elevated levels of serum gamma-globulin, IgG or the presence of autoantibodies. Diabetes mellitus was detected at presentation in 2 patients. imaging findings included CT showed diffuse (n=9) and focal (n=1) enlargement of pancreas. Minimal peripancreatic stranding was found in 7 patients, with no pancreatic pseudocyst and calcification. Six patients had enlarged peripancreatic lymph nodes. After contrast injection for 4 patients, delayed enhancement of the pancreatic parenchyma was observed, along with low-density capsule-like rim surrounding the pancreas. Magnetic resonance imaging showed diffuse enlargement of pancreas in 9 patients. MRCP showed diffuse (n=6) and segmental (n=3) irregular narrowing of the main pancreatic duct. B-mode ultrasound showed diffuse (n=9) and focal (n=1) enlargement of the pancreas. EUS showed diffuse (n=9) and focal (n=1) enlargement with hypoecho. ERCP showed stricture of distal common bile duct and irregular dilation of proximal bile ducts in 7 patients, diffuse stricture in main pancreatic duct in 4 patients, and segmental stricture in 3 patients. During the follow-up, abnormalities of imaging and serum markers were resolved after steroid therapy in 5 patients.</p><p><b>CONCLUSION</b>AIP is a distinctive type of chronic pancreatitis that shows specific imaging features.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pancreatitis
/
Autoantibodies
/
Autoimmune Diseases
/
Blood
/
Diagnostic Imaging
/
Tomography, X-Ray Computed
/
Retrospective Studies
/
Endosonography
/
Diagnosis
/
Allergy and Immunology
Type of study:
Diagnostic study
/
Observational study
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
Chinese
Journal:
Acta Academiae Medicinae Sinicae
Year:
2008
Type:
Article
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