Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Eur J Radiol. 2010 Jun;74(3):e22-8. doi: 10.1016/j.ejrad.2009.03.022. Epub 2009 Apr 16.
To clarify whether there are differences in MRI findings between pancreatic lymphomas and autoimmune pancreatitis (AIP).
MRI of 8 patients with pancreatic lymphomas and 21 patients with AIP were retrospectively reviewed. For multifocal pancreatic lymphomas (n=2) and AIP (n=4), the largest 2 lesions were evaluated. Ten pancreatic lymphomas and 25 AIP were compared on three bases: the signal intensity on T2-weighted images, internal homogeneity, and presence or absence of capsule-like rim. In 8 lymphomas and 19 AIP, the enhancement pattern on dynamic MRI was compared, as well.
On T2-weighted images, pancreatic lymphomas comprised 5, 5 and 4 lesions with low (iso), slightly high, and moderately high intensity, respectively, while the numbers for AIP were 14, 10, and 1 (P<0.01). Nine of 10 (90%) lymphomas appeared homogenous, and 11 of 25 (44%) AIP were homogenous (P<0.05). A capsule-like rim was present in 9 of 25 (36%) AIP, but was not seen in lymphomas (P<0.05). On dynamic MRI, 18 of 19 (94.7%) AIP showed persistent (n=5) or delayed enhancement (n=13), and 6 of 8 (75%) lymphomas showed low intensity without delayed enhancement (P<0.001).
MRI findings for pancreatic lymphomas and AIP were significantly different, which may be helpful for the differential diagnosis of these two diseases.
阐明胰腺淋巴瘤与自身免疫性胰腺炎（AIP）的 MRI 表现是否存在差异。
回顾性分析了 8 例胰腺淋巴瘤和 21 例 AIP 的 MRI 资料。对于 2 例多灶性胰腺淋巴瘤和 4 例 AIP，评估了最大的 2 个病灶。比较了 10 例胰腺淋巴瘤和 25 例 AIP 在以下三个方面的 MRI 表现：T2 加权图像上的信号强度、内部均匀性和有无包膜样边缘。对 8 例淋巴瘤和 19 例 AIP 的动态 MRI 增强模式也进行了比较。
T2 加权图像上，胰腺淋巴瘤分别有 5、5 和 4 个病灶表现为低（等）、稍高和中度高信号强度，而 AIP 的相应数字为 14、10 和 1（P<0.01）。10 例淋巴瘤中有 9 例（90%）表现为均匀，而 25 例 AIP 中有 11 例（44%）表现为均匀（P<0.05）。25 例 AIP 中有 9 例（36%）存在包膜样边缘，但在淋巴瘤中未见（P<0.05）。动态 MRI 上，19 例 AIP 中有 18 例（94.7%）表现为持续（n=5）或延迟增强（n=13），8 例淋巴瘤中有 6 例（75%）表现为无延迟增强的低信号强度（P<0.001）。
胰腺淋巴瘤和 AIP 的 MRI 表现存在显著差异，这可能有助于这两种疾病的鉴别诊断。
