Autoimmune pancreatitis and non-necrotizing acute pancreatitis: Computed tomography pattern

作者:Graziani Rossella*; Frulloni Luca; Mantovani William; Ambrosetti Maria Chiara; Mautone Simona; Re Thomas Joseph; Dal Bo Chiara; Manfredi Riccardo; Mucelli Roberto Pozzi
来源:Digestive and Liver Disease, 2012, 44(9): 759-766.
DOI:10.1016/j.dld.2012.03.013

摘要

Objectives: To retrospectively differentiate diffuse autoimmune pancreatitis from non-necrotizing acute pancreatitis at clinical onset with multi detector row computed tomography. %26lt;br%26gt;Methods: 36 Patients suffering from diffuse autoimmune pancreatitis (14) or non-necrotizing acute pancreatitis (22) were enrolled. Qualitative analysis included stranding, retroperitoneal fluid film, capsule-like rim enhancement and pleural effusion. In quantitative analysis pancreatic density was measured in all phases. The vascularization behaviour was assessed using the relative enhancement rate across all phases. %26lt;br%26gt;Results: Pancreatic density resulted lower in non-necrotizing acute pancreatitis compared to diffuse autoimmune pancreatitis patients in pre-contrast phase and higher in pancreatic phase. Relative enhancement rate evaluation confirmed different vascularization behaviours of the two diseases. Only non-necrotizing acute pancreatitis Patients presented peripancreatic stranding and fluid in the retromesenteric interfascial plane. %26lt;br%26gt;Conclusions: Multi detector row computed tomography is a useful technique for differentiating diffuse autoimmune pancreatitis from non-necrotizing acute pancreatitis at clinical onset. Peripancreatic stranding and retroperitoneal fluid film, characteristic of non-necrotizing acute pancreatitis, and late-phase peripheral rim enhancement, characteristic of diffuse autoimmune pancreatitis, provide qualitative clues to the differentiation. A quantitative study of contrast enhancement patterns, considering the relative enhancement rate, can assist in the differential diagnoses of two diseases.

  • 出版日期2012-9