- 作者：Rossella Graziani ; Luca Frulloni ; William Mantovani ; Maria Chiara Ambrosetti ; Simona Mautone ; Thomas Joseph Re ; Chiara Dal Bo ; Riccardo Manfredi ; Roberto Pozzi Mucelli
- 关键词：Autoimmune pancreatitis ; Multi detector row computed tomography ; Non-necrotizing acute pancreatitis
- 刊名：Digestive and Liver Disease
- 出版年：2012
- 出版时间：September, 2012
- 年：2012
- 卷：44
- 期：9
- 页码：759-766
- 全文大小：1449 K
Objectives
To retrospectively differentiate diffuse autoimmune pancreatitis from non-necrotizing acute pancreatitis at clinical onset with multi detector row computed tomography.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.
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.
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.