Lindström E, Ihse I
Department of Surgery, University Hospital, Linköping, Sweden.
Acta Radiol. 1989 Nov-Dec;30(6):609-13.
In 29 patients with abdominal pain the diagnosis of pancreas divisum (PD) was verified by endoscopic retrograde pancreatography (ERP) via both the major and the minor papilla. Computed tomography (CT) was done in all patients to evaluate contour, volume, antero-posterior diameters and attenuation values of the gland in comparison with a normal reference series. Also, the validity of the CT grading of pancreatitis was assessed in comparison with ERP grading. Patients with PD had an increased cranio-caudal diameter of the pancreatic head (p less than 0.001). Further, the main pancreatic duct was visualized more often in patients with PD (p less than 0.01), who also had an increasing frequency of pancreatic calcifications (p less than 0.05). Otherwise there were no differences compared with the normal series. The observed reduction in the volume of the gland in patients with marked pancreatitis at ERP seemingly reflected the severity of inflammation. No cleavage between the dorsal and ventral anlage was identified. CT was found to be too unspecific to be of any use in grading of pancreatitis. In conclusion, CT findings in patients with PD are sparse, unspecific and preferably a reflection of pancreatitis, if present. ERP remains the 'gold standard' for the diagnosis.
在29例腹痛患者中，经内镜逆行胰胆管造影术（ERP）通过主乳头和副乳头证实了胰腺分裂（PD）的诊断。对所有患者均进行了计算机断层扫描（CT），以评估胰腺的轮廓、体积、前后径和衰减值，并与正常参考系列进行比较。此外，还将CT对胰腺炎的分级有效性与ERP分级进行了比较。PD患者胰头的头尾径增加（p<0.001）。此外，PD患者主胰管的显影更常见（p<0.01），胰腺钙化的频率也增加（p<0.05）。否则，与正常系列相比无差异。ERP显示，明显胰腺炎患者胰腺体积减小，这似乎反映了炎症的严重程度。未发现背侧和腹侧原基之间的分离。发现CT过于不特异，对胰腺炎分级没有任何用处。总之，PD患者的CT表现较少、不特异，如有胰腺炎存在，最好反映胰腺炎情况。ERP仍然是诊断的“金标准”。
