Huiping Shi MD, Presenter: Nothing to Disclose

Xiaoxuan Ma, Abstract Co-Author: Nothing to Disclose

Minxia Qiao, Abstract Co-Author: Nothing to Disclose

Fan Yang, Abstract Co-Author: Nothing to Disclose

Shibo Dong, Abstract Co-Author: Nothing to Disclose

To investigate the application value of the whole pancreas CTperfusion imaging in the diagnosis of autoimmune pancreatitis (AIP) and the differential diagnosis between the AIP and pancreatic carcinoma.

Seven cases of autoimmune pancreatitis and 8 pancreatic carcinoma underwent the whole pancreas perfusion CT imaging. The 18-gauge intravenous needle was placed into right antecubital vein and contrast medium Ultravist 40 ml(370 mg iodine/ml,6ml/s)was injected following normal saline 30 ml at the same speed. Perfusion scan and injection started at the same time. Total acquisition time lasted for 60s with 19 times volume CT scan and 6080 pictures. The CT findings and perfusion parameters of all cases were analysed and compared,such as,diffuse enlargement/focal lesion of pancreas,pancreatic duct changes such as its' stricture, expansion or truncation,adjacent blood vessels involvement, the features of the time-density curve, characteristics of the perfusion pseudo-color pictures and perfusion parameters,other autoimmune diseases manifeastion.

In 7 AIP cases, the lesions in 5 located at the head of the pancreas,2 body and tail, and 5 accompanied with pancreatic duct dilatation, 4 extrahepatic bile duct dilation, one ulcerative colitis. No blood vessels invasion was found in all cases. In 8 cases of pancreatic carcinoma,3 located at the pancreatic head,5 the body and tail, and 4 accompanied with dilation of pancreatic duct, 6 adjacent vascular invasion, and 2 extraheptic bile duct dilatation. Time-density curve analysis showed the enhancement pattern of AIP was similar to that of the normal pancreatic tissue, but the degree of the enhancement was significantly reduced. The shape of the time-density curve had a significantly difference between pancreatic carcinoma and the normal pancreatic tissue in which the former demonstrated a much lower enhancement pattern than the letter. The mean AF value had a stistically significant difference(p<0.05) between AIP and pancreatic carcinoma (82.6 vs 69.7ml/min/100ml) in statistical analysis of Variance.

As a supplement method of routine CT examination, CT perfusion imaging could demonstrate characteristics of AIP, and would play an important role in the diagnosis and differential diagnosis of AIP.

CT perfusion can demonstrate the blood supply features of the pancreas disease and helpful for the diagnosis of autoimmune pancreatitis.

Shi, H, Ma, X, Qiao, M, Yang, F, Dong, S, The Application Value of the CT Perfusion Imaging in the Diagnosis of Autoimmune Pancreatitis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045736.html