慢性胰腺炎脾门假性囊肿分类及其与SPH关系的影像学研究

徐浩铜, 徐万宇, 吴毅, 何明静, 雷秀兵, 田伏洲

中国临床解剖学杂志 ›› 2023, Vol. 41 ›› Issue (6) : 652-656.

PDF(4468 KB)
PDF(4468 KB)
中国临床解剖学杂志 ›› 2023, Vol. 41 ›› Issue (6) : 652-656.
断层影像解剖

慢性胰腺炎脾门假性囊肿分类及其与SPH关系的影像学研究

  • 徐浩铜1,2,    徐万宇1,    吴毅3,    何明静1,    雷秀兵1,    田伏洲2*
作者信息 +

Imaging study on classification of pseudocysts of splenic hilum in chronic pancreatitis and its relationship with sinistral portal hypertation 

  • Xu Haotong1,2, Xu Wanyu1, Wu Yi3, He Mingjing1, Lei Xiubing1, Tian Fuzhou2*
Author information +
文章历史 +

摘要

目的    为鉴别脾门假性囊肿与脾内假性囊肿、脾周局灶性积液,运用影像学和2号中国可视人(second Chinese Visible Human,CVH2)数据库归纳脾门假性囊肿分类,探究脾门假性囊肿和左侧区域性门静脉高压(sinistral portal hypertation,SPH)的潜在关系。  方法    采集2019年291例慢性胰腺炎患者CT或MRI图像,归纳脾门假性囊肿分类,在CVH2图像上模拟本影像学脾门假性囊肿分类法,分析脾门假性囊肿与SPH之间的潜在关系。  结果    脾门假性囊肿可分为3类:胰尾假性囊肿扩张至脾门,并进一步伸入脾实质形成脾门假性囊肿;主胰管瘘发展成脾门假性囊肿;胰尾假性囊肿和胰瘘共同形成脾门假性囊肿。脾门假性囊肿是SPH的重要风险预测指标(OR=7.88,P<0.001)。  结论    运用可视化技术归纳并虚拟展示脾门假性囊肿分类法,对后续治疗方案的选择起指导作用。

Abstract

 Objective To avoid to mix pseudocysts of splenic hilum (POSH) with introsplenic pseudocysts or peripancreatic fluid collections, radiological images and the second Chinese Visible Human (CVH2) datasets were used to summarize the classification of the POSH, and to explore potential correlation between the POSH and the sinistral portal hypertation (SPH). Methods The classification of POSH was summarized on CT or MRI from 291 patients with chronic pancreatitis in 2019. The classification of the POSH discovered on radiological images was mimicked on CVH2 images. The potential correlation between the POSH and the SPH was explored by statistical analyses. Results The POSH might be classified into three categories: one was that pseudocysts of pancreatic tail (POPT) developed to the splenic hilum area and extended into the splenic parenchyma to form the POSH, another one was that the POSH developed from the fistula of the pancreatic duct, and the third one was that both the POPT and the pancreatic fistula formed the POSH. The presence of a POSH was a risk factor for the SPH (OR=7.88; P<0.001). Conclusions The classification of the POSH has been summarized and displayed virtually by visualization technology. Mastering the detailed types of the POSH will decide on the choosing of the therapeutic strategy.

关键词

脾门假性囊肿;  /   / 胰瘘; 左侧区域性门静脉高压; 可视化; 中国可视人

Key words

Pseudocyst of splenic hilum; Pancreatic fistula; Sinistral portal hypertension / Visualization; Chinese Visible Human

引用本文

导出引用
徐浩铜, 徐万宇, 吴毅, 何明静, 雷秀兵, 田伏洲. 慢性胰腺炎脾门假性囊肿分类及其与SPH关系的影像学研究[J]. 中国临床解剖学杂志. 2023, 41(6): 652-656
Xu Haotong, Xu Wanyu, Wu Yi, He Mingjing, Lei Xiubing, Tian Fuzhou. Imaging study on classification of pseudocysts of splenic hilum in chronic pancreatitis and its relationship with sinistral portal hypertation [J]. Chinese Journal of Clinical Anatomy. 2023, 41(6): 652-656
中图分类号: R322.21    

参考文献

[1] Tirkes T. Chronic pancreatitis: what the clinician wants to know from MR imaging[J]. Magn Reson Imaging Clin N Am, 2018, 26(3): 451-461. DOI: 10.1016/j.mric.2018.03.012.
[2] Tyberg A, Karia K, Gabr M, et al. Management of pancreatic fluid collections: a comprehensive review of the literature[J]. World J Gastroenterol, 2016, 22(7): 2256-2270. DOI: 10.3748/wjg.v22.i7.2256.
[3] Goyal S, Goyal S, Garg M, et al. Pseudopancreatic cyst invasion into spleen: case report and review[J]. Journal of Mahatma Gandhi Institute of Medical Sciences, 2014, 19(2): 151-154. DOI: 10.4103/0971-9903.138443.
[4] Gamanagatti S, Kandpal H, Mishra V. Acute pancreatitis complicated by intrasplenic and intrahepatic pseudocysts[J]. European Journal of Radiology Extra, 2006, 60(1): 29-31. DOI: 10.1016/j.ejrex.2006.06.008.
[5] Hokama A, Maeda K, Tomiyama R, et al. Intrasplenic pancreatic pseudocysts[J]. Jop, 2004, 5(4): 235-236. DOI: 10.1016/0002-9610(72)90096-7.
[6] Trivedi H, Shuja A, Shah BB. Intrasplenic pancreatic pseudocyst: a rare complication of acute pancreatitis[J]. ACG Case Rep J, 2015, 2(4): 202-203. DOI: 10.14309/crj.2015.57.
[7] Mortelé KJ, Mergo PJ, Taylor HM, et al. Splenic and perisplenic involvement in acute pancreatitis: determination of prevalence and morphologic helical CT features[J]. J Comput Assist Tomogr, 2001, 25(1): 50-54. DOI: 10.1097/00004728-200101000-00009.
[8] Dumonceau JM, Macias-Gomez C. Endoscopic management of complications of chronic pancreatitis[J]. World J Gastroenterol, 2013, 19(42): 7308-7315. DOI: 10.3748/wjg.v19.i42.7308.
[9] Flati G, Andrén-Sandberg Å, La Pinta M, et al. Potentially fatal bleeding in acute pancreatitis: pathophysiology, prevention, and treatment[J]. Pancreas, 2003, 26(1): 8-14. DOI: 10.1097/00006676-200301000-00002.
[10]Conwell DL, Lee LS, Yadav D. American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: evidence-based report on diagnostic guidelines[J]. Pancreas, 2014, 43(8): 1143-1162. DOI: 10.1097/MPA.0000000000000237.
[11] 李磊, 邱法波, 朱敏. 胰腺真性囊肿266例回顾性分析[J]. 齐鲁医学杂志, 2016, 31(2): 171-173. DOI: 10.13362/j.qlyx.201602015.
[12] Zhang SX, Heng PA, Liu ZJ. Chinese visible human project[J]. Clin Anat, 2006, 19(3): 204-215. DOI: 10.1002/ca.20273f.
[13] Zhao Z, Liu S, Li Z, et al. Sectional anatomy of the peritoneal reflections of the upper abdomen in the coronal plane[J]. J Comput Assist Tomogr, 2005, 29(4): 430-437. DOI: 10.1097/01.rct.0000164259.91057.af.
[14] Nealon WH, Walser E. Main pancreatic ductal anatomy can direct choice of modality for treating pancreatic pseudocysts (surgery versus percutaneous drainage)[J]. Ann Surg, 2002, 235(6): 751-758. DOI: 10.1097/00000658-200206000-00001.
[15] Zhang AB, Zheng SS. Treatment of pancreatic pseudocysts in line with D'Egidio's classification[J]. World J Gastroenterol, 2005, 11(5): 729-732. DOI: 10.3748/wjg.v11.i5.729.
[16] Koklu S, Coban S, Yuksel O, et al. Left-sided portal hypertension[J]. Dig Dis Sci, 2007, 52(5): 1141-1149. DOI: 10.1007/s10620-006-9307-x.
[17] Zafar M, Heslop-Harrison W, Loterh L, et al. Splenic vein thrombosis: a case series of consequential chronic pancreatitis and sequential myeloproliferative disorder[J]. Cureus, 2022, 14(6): e25924. DOI: 10.7759/cureus.25924.
[18]Bernades P, Baetz A, Lévy P, et al. Splenic and portal venous obstruction in chronic pancreatitis. A prospective longitudinal study of a medical-surgical series of 266 patients [J]. Dig Dis Sci, 1992, 37(3): 340-346. DOI: 10.1007/BF01307725.
[19] 侯宝华, 区金锐. 胰腺假性囊肿的分类及临床治疗 [J]. 岭南现代临床外科,2009, 9(2): 93-95,100. DOI:10.3969/j.issn.1009-976X. 2009. 02.006.

基金

国家重点研发计划项目子课题(2018YFC0116901);攀枝花学院博士启动基金项目(035200147);攀枝花学院2020年校级项目(035001416)

PDF(4468 KB)

Accesses

Citation

Detail

段落导航
相关文章

/