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IgG4相关性硬化性胆管炎与胆管癌鉴别诊断中的临床特征及CT表现

[Clinical features and CT findings in the differential diagnosis of IgG4-related sclerosing cholangitis and cholangiocarcinoma].

作者信息

Matsusaki Shimpei, Kikuyama Masataka, Kawakami Hiroshi, Kubota Kensuke, Maguchi Hiroyuki

机构信息

Department of Gastroenterology, Suzuka General Hospital.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2013 Apr;110(4):615-21.

Abstract

To clarify the clinical features and CT findings of IgG4-related sclerosing cholangitis (IgG4-SC), we reviewed 16 cases of IgG4-SC and 10 cases of cholangiocarcinoma concerning patient background, treatment, outcomes and CT findings. The median age of IgG4-SC cases was 70 (range 54-79) years, and only 1 was a woman. Serum IgG4 level of all IgG4-SC patients were elevated and in 13 patients steroid therapy proved effective. The CT findings were analyzed with regard to the biliary strictures (symmetry, outer margin, inner margin), wall enhancement pattern and pancreas size. The CT findings of symmetric wall thickness and total scores were significantly higher in IgG4-SC than in cholangiocarcinoma. Although the small number of patients in this study is a limitation, the CT findings may help distinguish IgG4-SC from cholangiocarcinoma.

摘要

为阐明IgG4相关性硬化性胆管炎(IgG4-SC)的临床特征和CT表现,我们回顾了16例IgG4-SC患者和10例胆管癌患者的患者背景、治疗、预后及CT表现。IgG4-SC患者的中位年龄为70岁(范围54-79岁),仅1例为女性。所有IgG4-SC患者的血清IgG4水平均升高,13例患者的类固醇治疗证明有效。对胆管狭窄(对称性、外缘、内缘)、壁强化模式和胰腺大小的CT表现进行了分析。IgG4-SC患者的对称壁厚度和总分的CT表现显著高于胆管癌患者。尽管本研究中的患者数量较少是一个局限性,但CT表现可能有助于鉴别IgG4-SC和胆管癌。

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