Yang Cai-Wei, Che Feng, Liu Xi-Jiao, Yin Yuan, Zhang Bo, Song Bin
West China School of Medicine, Sichuan University, Chengdu, 610041, China.
Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
Insights Imaging. 2021 Oct 21;12(1):144. doi: 10.1186/s13244-021-01089-0.
Heterotopic pancreas (HP) is an uncommon congenital abnormality in the developmental process of the pancreas, with gastrointestinal heterotopic pancreas (GHP) being the most common HP. The clinical manifestations of GHP may have variable patterns of presentation, dictated by both the anatomic location and the functional ability of the lesion. The most common imaging modality in detecting GHP is computed tomography (CT), while gastrointestinal barium fluoroscopy, endoscopic ultrasonography, and magnetic resonance imaging (MRI) are also applied. The density and enhancement patterns of GHP are consistent with histological classifications. GHP with a predominantly acinar tissue component manifests homogeneous and marked enhancement on CT images, whereas a predominantly ductal GHP presents heterogeneous and mild enhancement. On MRI, the appearance and signal intensity of GHP were paralleled to the normal pancreas on all sequences and were characterized by T1-weighted high signal and early marked enhancement. This article provides a comprehensive review of the histopathology, clinical manifestations, imaging features of various modalities, and differential diagnosis of GHP. It is hoped that this review will improve clinicians' knowledge of GHP and aid in accurate preoperative diagnosis, thereby reducing the misdiagnosis rate.
异位胰腺（HP）是胰腺发育过程中一种罕见的先天性异常，其中胃肠道异位胰腺（GHP）是最常见的HP类型。GHP的临床表现可能具有多种呈现方式，这取决于病变的解剖位置和功能能力。检测GHP最常用的影像学检查方法是计算机断层扫描（CT），同时也会应用胃肠道钡餐透视、内镜超声检查和磁共振成像（MRI）。GHP的密度和强化模式与组织学分类一致。以腺泡组织成分为主的GHP在CT图像上表现为均匀且明显的强化，而以导管成分为主的GHP则呈现不均匀且轻度的强化。在MRI上，GHP在所有序列上的表现和信号强度与正常胰腺相似，其特征为T1加权像高信号和早期明显强化。本文对GHP的组织病理学、临床表现、各种影像学特征及鉴别诊断进行了全面综述。希望本综述能提高临床医生对GHP的认识，并有助于准确的术前诊断，从而降低误诊率。
