Takahashi Masaaki, Fujinaga Yasunari, Notohara Kenji, Koyama Takashi, Inoue Dai, Irie Hiroyuki, Gabata Toshifumi, Kadoya Masumi, Kawa Shigeyuki, Okazaki Kazuichi
Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
Department of Anatomic Pathology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
Jpn J Radiol. 2020 Jul;38(7):591-612. doi: 10.1007/s11604-020-00971-z. Epub 2020 Apr 15.
The International Consensus Diagnosis Criteria for autoimmune pancreatitis (AIP) has been published internationally for the diagnosis of AIP. However, since the revisions in 2006 and 2011, the Clinical Diagnostic Criteria for Autoimmune Pancreatitis 2018 have been published. The criteria were revised based the Clinical Diagnostic Criteria 2011, and included descriptions of characteristic imaging findings such as (1) pancreatic enlargement and (2) distinctive narrowing of the main pancreatic duct. In addition, pancreatic duct images obtained by magnetic resonance cholangiopancreatography as well as conventional endoscopic retrograde pancreatography were newly adopted. The guideline explains some characteristic imaging findings, but does not contain descriptions of the imaging methods, such as detailed imaging parameters and optimal timings of dynamic contrast-enhanced computed tomography/magnetic resonance imaging. It is a matter of concern that imaging methods can vary from hospital to hospital. Although other characteristic findings have been reported, these findings were not described in the guideline. The present paper describes the imaging methods for obtaining optimal images and the characteristic imaging findings with the aim of standardizing image quality and improving diagnostic accuracy when radiologists diagnose AIP in actual clinical settings.
国际自身免疫性胰腺炎(AIP)共识诊断标准已在国际上发表用于AIP的诊断。然而,自2006年和2011年修订以来,《2018年自身免疫性胰腺炎临床诊断标准》已发布。该标准基于2011年临床诊断标准进行修订,包括对特征性影像学表现的描述,如(1)胰腺肿大和(2)主胰管明显狭窄。此外,新采用了磁共振胰胆管造影以及传统内镜逆行胰胆管造影获得的胰管图像。该指南解释了一些特征性影像学表现,但未包含成像方法的描述,如动态对比增强计算机断层扫描/磁共振成像的详细成像参数和最佳时机。令人担忧的是,不同医院的成像方法可能不同。尽管已报道了其他特征性表现,但这些表现在指南中并未描述。本文描述了获取最佳图像的成像方法和特征性影像学表现,目的是在放射科医生于实际临床环境中诊断AIP时规范图像质量并提高诊断准确性。