Istituto di Radiologia, Università di Verona, P.le L.A. Scuro 10, 37134, Verona, Italy.
Radiol Med. 2012 Dec;117(8):1275-86. doi: 10.1007/s11547-012-0888-4. Epub 2012 Oct 22.
This study prospectively assessed whether the presence of a bull's-eye pattern of pancreatic-duct stones on multidetector computed tomography (MDCT) correlated with gene-mutation-associated pancreatitis (GMAP) and whether other signs suggestive of GMAP can be detected with MDCT.
Forty-seven patients with chronic calcific pancreatitis underwent genetic testing for CFTR, SPINK1 and PRSS1 mutations and an MDCT scan of the abdomen. Qualitative analysis assessed the presence or absence of pancreatic-duct stones with bull's-eye appearance. Quantitative analysis included the number and maximum diameter of stones and the diameter of the main pancreatic duct.
Fifteen of 47 patients (32%) were positive for gene mutations (GMAP patients). The bull's-eye pattern was found in 10/15 patients (67%) with GMAP and in 4/32 (12%) patients with chronic pancreatitis not associated with GMAP (NGMAP; p<0.0001). The mean diameter of duct stones was 15 mm in patients with GMAP and 10 mm in patients with NGMAP (p<0.04).
The presence of duct stones with a bull's-eye pattern correlates with GMAP. Duct stones with diameter ≥15 mm are another sign suggestive of GMAP.
本研究前瞻性评估多排螺旋 CT（MDCT）上胰管结石呈靶心征是否与基因相关胰腺炎（GMAP）相关，以及 MDCT 是否能检测到其他提示 GMAP 的征象。
47 例慢性钙化性胰腺炎患者接受 CFTR、SPINK1 和 PRSS1 基因突变的基因检测和腹部 MDCT 扫描。定性分析评估胰管结石是否存在靶心征。定量分析包括结石的数量、最大直径和主胰管的直径。
47 例患者中有 15 例（32%）基因突变阳性（GMAP 患者）。GMAP 患者中 10/15 例（67%）存在靶心征，而慢性胰腺炎不伴 GMAP 患者中 4/32 例（12%）存在靶心征（p<0.0001）。GMAP 患者的胰管结石平均直径为 15mm，而 NGMAP 患者的胰管结石平均直径为 10mm（p<0.04）。
胰管结石呈靶心征与 GMAP 相关。直径≥15mm 的胰管结石是提示 GMAP 的另一征象。
