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胰腺脂肪变性是一种常见病变吗?

Is a fatty pancreas a banal lesion?

作者信息

Smereczyński Andrzej, Kołaczyk Katarzyna

机构信息

Self-Training Ultrasonography Circle at the Genetics and Pathomorphology Center in Szczecin, Szczecin, Poland.

出版信息

J Ultrason. 2016 Sep;16(66):273-80. doi: 10.15557/JoU.2016.0027. Epub 2016 Sep 7.

Abstract

So far, a fatty pancreas has been related to obesity and the ageing processes in the body. The current list of pathogenetic factors of the condition is clearly extended with genetically conditioned diseases (cystic fibrosis, Shwachman-Diamond syndrome and Johanson-Blizzard syndrome), pancreatitis, especially hereditary and obstructive, metabolic and hormonal disorders (hypertriglyceridemia, hypercholesterolemia, hyperinsulinemia and hypercortisolemia), alcohol overuse, taking some medicines (especially adrenal cortex hormones), disease of the liver and visceral adiposis. As regards lipomatosis of that organ resulting mainly from dyslipidemia and hyperglycemia, the term "nonalcoholic fatty pancreas disease" was introduced. Experimental studies on animals and histological preparations of the pancreatic fragments show that the lipotoxicity of the collected adipocytes collected ion the organ release a cascade of proinflammatory phenomena, and even induces the processes of carcinogenesis. Pancreas adiposis is best defined in Computed Tomography and Magnetic Resonance Imaging. However, a series of works proved the usefulness in the diagnostics of that pathology of transabdominal and endoscopic ultrasonography. In that method, the degree of adiposis was based on the comparison of echogenicity of the pancreas and the liver, renal parenchyma, spleen and/or retroperitoneal adipose. Recently, the evaluation was expanded by the evaluation of the degree of pancreatic adipose with the pancreas-to-liver index, utilizing to that end a special computer program. According to our experience, the simplest solution is the method utilized by us. On one crosssection of the body of the pancreas, its echogenicity is assessed in comparison to retroperitoneal adipose and the visibility of the splenic vein, pancreatic duct and the major retroperitoneal vessels. Depending on the visualization of these structures, it is possible to determine the degree of pancreas adiposis. Such a study applies to 250 people, in whom the adiposis was detected in 16.5%, which is close to other cohort US examinations results.

摘要

到目前为止,胰腺脂肪化与肥胖及身体的衰老过程有关。目前该病症的致病因素清单因遗传性疾病(囊性纤维化、施瓦赫曼-戴蒙德综合征和乔汉森- Blizzard综合征)、胰腺炎(尤其是遗传性和梗阻性胰腺炎)、代谢和激素紊乱(高甘油三酯血症、高胆固醇血症、高胰岛素血症和高皮质醇血症)、酒精过度使用、服用某些药物(尤其是肾上腺皮质激素)、肝脏疾病和内脏脂肪过多症而明显扩充。关于主要由血脂异常和高血糖导致的该器官脂肪瘤病,引入了“非酒精性脂肪性胰腺疾病”这一术语。对动物的实验研究以及胰腺组织切片显示,器官中收集的脂肪细胞的脂毒性会引发一系列促炎现象,甚至诱发癌变过程。胰腺脂肪过多症在计算机断层扫描和磁共振成像中最易明确诊断。然而,一系列研究证明经腹和内镜超声检查在该病理诊断中也很有用。在该方法中,脂肪过多症的程度是基于胰腺与肝脏、肾实质、脾脏和/或腹膜后脂肪的回声性比较。最近,通过使用特殊计算机程序,利用胰腺与肝脏指数评估胰腺脂肪程度,使评估得到了扩展。根据我们的经验,最简单的方法是我们采用的方法。在胰腺体部的一个横断面上,将其回声性与腹膜后脂肪以及脾静脉、胰管和主要腹膜后血管的可见性进行比较来评估。根据这些结构的可视情况,可以确定胰腺脂肪过多症的程度。这项研究适用于250人,其中16.5%检测出有脂肪过多症,这与其他队列的超声检查结果相近。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45c1/5034021/adc3395dd5e5/JoU-2016-0027-g001.jpg

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