Imaging features of ectopic pancreas in gastrointestinal tract_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Ju ¹ ,  YIN Longlin ^1,2

1. Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;
2. Department of Radiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu 610072, P. R. China;

Corresponding?author：

YIN Longlin, Email: yinlonglin@163.com

Keywords：

ectopic pancreas; gastrointestinal tract; computed tomography; magnetic resonance imaging

DOI：

10.7507/1007-9424.201908009

Video：

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Objective To analyze and conclude CT and MRI imaging features of ectopic pancreas in gastrointestinal tract so as to improve the understanding of the features.Methods The clinical, imaging, and pathological data of 12 patients with ectopic pancreas in the gastrointestinal tract confirmed by the pathology in the Sichuan Provincial People’s Hospital from November 2016 to June 2019 were retrospectively analyzed. The characteristics of image presentation were summarized.Results ① The anatomical distribution: all patients had a single lesion. Of the 12 cases, 6 cases located in the gastric body lesser curvature, 3 cases located in the gastric angle, 1 case located in the posterior wall of gastric antrum, 1 case occurred in the upper jejunum, and 1 case occurred in the terminal ileum; 8 cases located in the submucosa, 2 cases located in the submucosa and muscular layer simultaneously, 1 case located in the submucosa, muscular and serous layer simultaneously, and 1 case located in the muscular layer. ② Size of the lesions: the maxium dimensions of the lesions were all 3 cm or less, and the long axes of the lesions were parallel to the gastrointestinal tract wall in 10 cases. ③ The internal characteristics: the results of 9 of 11 cases showed the isodensity compared to main pancreas on the plain CT scan. The results of 8 patients with enhanced CT showed the moderate to obvious enhancement, with 2 cases showed the slightly enhanced flaky or tube-like foci. In the arterial phase and portal venous phase, 6 cases showed the isodensity compared to main pancreas respectively. The result of MRI in 1 patient showed the isointensity compared to main pancreas on the plain scan and obviously heterogeneous enhancement.Conclusion CT and MRI could provide some information about location, size, and internal density or intensity of ectopic pancreas, and could be helpful for diagnosis.

Citation： SUN Ju, YIN Longlin. Imaging features of ectopic pancreas in gastrointestinal tract. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(11): 1346-1349. doi: 10.7507/1007-9424.201908009 Copy

1.	Attwell A, Sams S, Fukami N. Diagnosis of ectopic pancreas by endoscopic ultrasound with fine-needle aspiration. World J Gastroenterol, 2015, 21(8): 2367-2373.
2.	Subasinghe D, Sivaganesh S, Perera N, et al. Gastric fundal heterotopic pancreas mimicking a gastrointestinal stromal tumour (GIST): a case report and a brief review. BMC Res Notes, 2016, 9: 185.
3.	Zińczuk J, Bandurski R, Pryczynicz A, et al. Ectopic pancreas imitating gastrointestinal stromal tumor (GIST) in the stomach. Pol Przegl Chir, 2015, 87(5): 268-271.
4.	Sathyanarayana SA, Deutsch GB, Bajaj J, et al. Ectopic pancreas: a diagnostic dilemma. Int J Angiol, 2012, 21(3): 177-180.
5.	尉從新. 胃腸道異位胰腺的 CT 表現與病理對照分析. 實用放射學雜志, 2018, 34(3): 382-385.
6.	胡小紅, 王成林, 邱立城, 等. 腹部異位胰腺的 CT 診斷. 中國 CT 和 MRI 雜志, 2017, 15(1): 73-75.
7.	吳志濤. 腹部異位胰腺的 CT 診斷臨床分析. 實用醫技雜志, 2017, 24(10): 1059-1061.
8.	Li LM, Feng LY, Chen XH, et al. Gastric heterotopic pancreas and stromal tumors smaller than 3 cm in diameter: clinical and computed tomography findings. Cancer Imaging, 2018, 18(1): 26.
9.	Trifan A, Tarcoveanu E, Danciu M, et al. Gastric heterotopic pancreas: an unusual case and review of the literature. J Gastrointestin Liver Dis, 2012, 21(2): 209-212.
10.	張春來, 趙明澤, 唐雙玥, 等. 上消化道異位胰腺 MSCT 多期增強掃描特征. 中國醫學影像技術, 2017, 33(1): 66-69.
11.	Wawrzynski J, Leon L, Shah SA, et al. Gastric heterotopic pancreas presenting as abdominal pain with acute and chronic pancreatitis in the resected specimen. Case Rep Gastrointest Med, 2019, 2019: 2021712.
12.	夏振元, 李偉雄, 何華, 等. 十二指腸異位胰腺的臨床特點及影像學誤診分析. 中國臨床醫學影像雜志, 2017, 28(7): 500-503.
13.	陳秀珍, 黃文藪, 陳建寧, 等. 消化道異位胰腺的 MDCT 表現分析. 中國 CT 和 MRI 雜志, 2015, 13(7): 60-63.
14.	白麗芬, 零春潤, 葉州, 等. Meckel 憩室并胰腺及胃黏膜組織異位致消化道出血 1 例報道. 中國普外基礎與臨床雜志, 2018, 25(4): 510-511.
15.	陳偉. 胃部異位胰腺的多層螺旋 CT 表現. 中國醫學影像學雜志, 2015, 23(5): 361-363, 368.
16.	魏赟, 鄒海華, 余靜, 等. CT 對胃腸道異位胰腺和間質瘤的鑒別診斷. 醫學影像學雜志, 2018, 28(2): 246-250.
17.	Jang KM, Kim SH, Park HJ, et al. Ectopic pancreas in upper gastrointestinal tract: MRI findings with emphasis on differentiation from submucosa tumor. Acta Radiol, 2013, 54(10): 1107-1116.
18.	王華, 王伯胤, 王挺, 等. 胃異位胰腺 6 例. 中國醫學計算機成像雜志, 2018, 24(3): 272-274.
19.	宋瑞, 彭健. 腹部異位胰腺增強 CT 表現. 放射學實踐, 2019, 34(1): 41-44.
20.	王華, 王伯胤, 趙振華, 等. 胃及十二指腸異位胰腺 10 例 CT 征象分析. 中華全科醫師雜志, 2016, 15(12): 951-954.

1. Attwell A, Sams S, Fukami N. Diagnosis of ectopic pancreas by endoscopic ultrasound with fine-needle aspiration. World J Gastroenterol, 2015, 21(8): 2367-2373.
2. Subasinghe D, Sivaganesh S, Perera N, et al. Gastric fundal heterotopic pancreas mimicking a gastrointestinal stromal tumour (GIST): a case report and a brief review. BMC Res Notes, 2016, 9: 185.
3. Zińczuk J, Bandurski R, Pryczynicz A, et al. Ectopic pancreas imitating gastrointestinal stromal tumor (GIST) in the stomach. Pol Przegl Chir, 2015, 87(5): 268-271.
4. Sathyanarayana SA, Deutsch GB, Bajaj J, et al. Ectopic pancreas: a diagnostic dilemma. Int J Angiol, 2012, 21(3): 177-180.
5. 尉從新. 胃腸道異位胰腺的 CT 表現與病理對照分析. 實用放射學雜志, 2018, 34(3): 382-385.
6. 胡小紅, 王成林, 邱立城, 等. 腹部異位胰腺的 CT 診斷. 中國 CT 和 MRI 雜志, 2017, 15(1): 73-75.
7. 吳志濤. 腹部異位胰腺的 CT 診斷臨床分析. 實用醫技雜志, 2017, 24(10): 1059-1061.
8. Li LM, Feng LY, Chen XH, et al. Gastric heterotopic pancreas and stromal tumors smaller than 3 cm in diameter: clinical and computed tomography findings. Cancer Imaging, 2018, 18(1): 26.
9. Trifan A, Tarcoveanu E, Danciu M, et al. Gastric heterotopic pancreas: an unusual case and review of the literature. J Gastrointestin Liver Dis, 2012, 21(2): 209-212.
10. 張春來, 趙明澤, 唐雙玥, 等. 上消化道異位胰腺 MSCT 多期增強掃描特征. 中國醫學影像技術, 2017, 33(1): 66-69.
11. Wawrzynski J, Leon L, Shah SA, et al. Gastric heterotopic pancreas presenting as abdominal pain with acute and chronic pancreatitis in the resected specimen. Case Rep Gastrointest Med, 2019, 2019: 2021712.
12. 夏振元, 李偉雄, 何華, 等. 十二指腸異位胰腺的臨床特點及影像學誤診分析. 中國臨床醫學影像雜志, 2017, 28(7): 500-503.
13. 陳秀珍, 黃文藪, 陳建寧, 等. 消化道異位胰腺的 MDCT 表現分析. 中國 CT 和 MRI 雜志, 2015, 13(7): 60-63.
14. 白麗芬, 零春潤, 葉州, 等. Meckel 憩室并胰腺及胃黏膜組織異位致消化道出血 1 例報道. 中國普外基礎與臨床雜志, 2018, 25(4): 510-511.
15. 陳偉. 胃部異位胰腺的多層螺旋 CT 表現. 中國醫學影像學雜志, 2015, 23(5): 361-363, 368.
16. 魏赟, 鄒海華, 余靜, 等. CT 對胃腸道異位胰腺和間質瘤的鑒別診斷. 醫學影像學雜志, 2018, 28(2): 246-250.
17. Jang KM, Kim SH, Park HJ, et al. Ectopic pancreas in upper gastrointestinal tract: MRI findings with emphasis on differentiation from submucosa tumor. Acta Radiol, 2013, 54(10): 1107-1116.
18. 王華, 王伯胤, 王挺, 等. 胃異位胰腺 6 例. 中國醫學計算機成像雜志, 2018, 24(3): 272-274.
19. 宋瑞, 彭健. 腹部異位胰腺增強 CT 表現. 放射學實踐, 2019, 34(1): 41-44.
20. 王華, 王伯胤, 趙振華, 等. 胃及十二指腸異位胰腺 10 例 CT 征象分析. 中華全科醫師雜志, 2016, 15(12): 951-954.

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Imaging features of ectopic pancreas in gastrointestinal tract

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