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.	尉从新. 胃肠道异位胰腺的 CT 表现与病理对照分析. 实用放射学杂志, 2018, 34(3): 382-385.
6.	胡小红, 王成林, 邱立城, 等. 腹部异位胰腺的 CT 诊断. 中国 CT 和 MRI 杂志, 2017, 15(1): 73-75.
7.	吴志涛. 腹部异位胰腺的 CT 诊断临床分析. 实用医技杂志, 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, Târcoveanu 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.	张春来, 赵明泽, 唐双玥, 等. 上消化道异位胰腺 MSCT 多期增强扫描特征. 中国医学影像技术, 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, 李伟雄, 何华, 等. 十二指肠异位胰腺的临床特点及影像学误诊分析. 中国临床医学影像杂志, 2017, 28(7): 500-503.
13.	陈秀珍, 黄文薮, 陈建宁, 等. 消化道异位胰腺的 MDCT 表现分析. 中国 CT 和 MRI 杂志, 2015, 13(7): 60-63.
14.	白丽芬, 零春润, 叶州, 等. Meckel 憩室并胰腺及胃黏膜组织异位致消化道出血 1 例报道. 中国普外基础与临床杂志, 2018, 25(4): 510-511.
15.	陈伟. 胃部异位胰腺的多层螺旋 CT 表现. 中国医学影像学杂志, 2015, 23(5): 361-363, 368.
16.	魏赟, 邹海华, 余静, 等. CT 对胃肠道异位胰腺和间质瘤的鉴别诊断. 医学影像学杂志, 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.	王华, 王伯胤, 王挺, 等. 胃异位胰腺 6 例. 中国医学计算机成像杂志, 2018, 24(3): 272-274.
19.	宋瑞, 彭健. 腹部异位胰腺增强 CT 表现. 放射学实践, 2019, 34(1): 41-44.
20.	王华, 王伯胤, 赵振华, 等. 胃及十二指肠异位胰腺 10 例 CT 征象分析. 中华全科医师杂志, 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. 尉从新. 胃肠道异位胰腺的 CT 表现与病理对照分析. 实用放射学杂志, 2018, 34(3): 382-385.
6. 胡小红, 王成林, 邱立城, 等. 腹部异位胰腺的 CT 诊断. 中国 CT 和 MRI 杂志, 2017, 15(1): 73-75.
7. 吴志涛. 腹部异位胰腺的 CT 诊断临床分析. 实用医技杂志, 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, Târcoveanu 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. 张春来, 赵明泽, 唐双玥, 等. 上消化道异位胰腺 MSCT 多期增强扫描特征. 中国医学影像技术, 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, 李伟雄, 何华, 等. 十二指肠异位胰腺的临床特点及影像学误诊分析. 中国临床医学影像杂志, 2017, 28(7): 500-503.
13. 陈秀珍, 黄文薮, 陈建宁, 等. 消化道异位胰腺的 MDCT 表现分析. 中国 CT 和 MRI 杂志, 2015, 13(7): 60-63.
14. 白丽芬, 零春润, 叶州, 等. Meckel 憩室并胰腺及胃黏膜组织异位致消化道出血 1 例报道. 中国普外基础与临床杂志, 2018, 25(4): 510-511.
15. 陈伟. 胃部异位胰腺的多层螺旋 CT 表现. 中国医学影像学杂志, 2015, 23(5): 361-363, 368.
16. 魏赟, 邹海华, 余静, 等. CT 对胃肠道异位胰腺和间质瘤的鉴别诊断. 医学影像学杂志, 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. 王华, 王伯胤, 王挺, 等. 胃异位胰腺 6 例. 中国医学计算机成像杂志, 2018, 24(3): 272-274.
19. 宋瑞, 彭健. 腹部异位胰腺增强 CT 表现. 放射学实践, 2019, 34(1): 41-44.
20. 王华, 王伯胤, 赵振华, 等. 胃及十二指肠异位胰腺 10 例 CT 征象分析. 中华全科医师杂志, 2016, 15(12): 951-954.

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Imaging features of ectopic pancreas in gastrointestinal tract

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