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目的分析胃部异位胰腺 CT 表现及其与病理的关系。方法回顾性分析15例经病理证实的胃部异位胰腺 CT 资料,其中11例进行了增强 CT 扫描,观察其 CT 表现特征。结果 15例均为单发病灶,最大直径1.3～3.1 cm,平均(1.9±0.2)cm。CT 平扫示病灶密度较均匀,无囊变或恶性变的病例。病灶呈圆形或卵圆形结节,与胃壁呈广基底;2例显示中央脐凹征。术前诊断正确2例,13例诊断不明确或误诊。病灶位于胃窦部11例,胃体部3例,胃底部1例;胃大弯侧10例,胃小弯侧5例。11例动态增强扫描中8例早期呈明显强化,类似胰腺强化和强化后的衰减,病理为胰腺腺泡组织为主;3例强化不明显,病理以胰腺导管及增生平滑肌为主。结论胃部异位胰腺发生部位具有特征性,CT 呈黏膜下病变特征;不同的强化方式与异位胰腺病理组成相关。
Objective To analyze the CT findings of gastric pancreas and its relationship with pathology. Methods A retrospective analysis of 15 cases of pathologically confirmed gastric ectopic pancreas CT data, including 11 cases of enhanced CT scan to observe the CT features. Results All the 15 cases were single lesions with the largest diameter of 1.3 ~ 3.1 cm, with an average of (1.9 ± 0.2) cm. CT scan show lesions more uniform density, no cystic degeneration or malignant transformation of the cases. The lesions were round or oval nodules, with a wide base with the stomach; 2 cases showed central umbilical depression sign. Preoperative diagnosis of 2 cases correctly, 13 cases of diagnosis is not clear or misdiagnosed. Lesions were located in the antrum of 11 cases, gastric body in 3 cases, 1 case of gastric fundus; gastric curvature in 10 cases, 5 cases of gastric lesser curvature. In the 11 cases of dynamic contrast-enhanced scanning, 8 cases showed obvious enhancement at early stage, similar to pancreatic enhancement and post-enhancement attenuation. The pathology was predominantly pancreatic acinar tissue. Three cases had no significant enhancement and the pathology was mainly pancreatic duct and hyperplasia smooth muscle. Conclusion The location of ectopic pancreas in the stomach is characteristic, and the submucosal lesions are characterized by CT. Different enhancement modes are associated with the pathological composition of the ectopic pancreas.