Objective To investigate the CT imaging features of pancreatic fatty replacement and its clinical significance. Methods Three patients with pancreatic fatty replacement detected by CT were retrospectively analyzed. CT examination included plain scan and contrast-enhanced scanning at the arterial and portal venous phases. The shape, size, density, pancreatic lobulation and interlobular spaces, course of the pancreatic duct were carefully observed. The clinic and laboratory data were also analyzed to determine the clinical significance of pancreatic fatty replacement. Results ①Imaging features: Two patients had complete fatty replacement involving the entire pancreas, another one had most fatty replacement sparing the posterior aspect of head and tail. Two patients had regular configuration of pancreas. The size of pancreas was slightly enlarged in 2 patients. Lobular atrophy and widening of interlobular spaces were present in all 3 patients. The pancreatic duct was normal in 3 patients. ②Clinic findings: Chronic diarrhea was present in 3 patients. Two patiens had diabetes （one had chronic cholangitis with choledochal lithiasis）， another one had small stone in the common bile duct. Serum lipase was low in 3 patients, of which one had low serum amylase. Conclusion Pancreatic fatty replacement demonstrates certain characteristic CT appearances, and is usually associated with disturbances of both the endocrine and exocrine functions of the pancreas.
Citation：
LI Yingchun,SONG Bin,XU Jun,YANG Yang,YIN Longlin.. atty Replacement of Pancreas: CT Appearances and Clinical Significance (Report of 3 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(6): 724-728. doi:
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- 1. Carucci LR, Jacobs JE. Focal fatty sparing of the pancreatic head in cystic fibrosis: CT findings [J].Abdom Imaging， 2003; 28(6)∶853.
- 2. 武忠弼， 杨光华主编. 中华外科病理学 [M]. 上卷. 第1版. 北京： 人民卫生出版社， 2002∶ 942～943.
- 3. Soyer P, Spelle L, Pelage JP, et al. Cystic fibrosis in adolescents and adults: fatty replacement of the pancreas——CT evaluation and functional correlation [J]. Radiology， 1999; 210(3)∶611.
- 4. Willi UV, Reddish JM, Teele RL. Cystic fibrosis: its characteristic appearance on abdominal sonography [J]. AJR Am J Roentgenol， 1980; 134(5)∶ 1005.
- 5. Tham RT, Heyerman HG, Falke TH, et al. Cystic fibrosis: MR imaging of the pancreas [J]. Radiology， 1991; 179(1)∶ 183.
- 6. Daneman A, Gaskin K, Martin DJ, et al. Pancreatic changes in cystic fibrosis: CT and sonographic appearances [J]. AJR Am J Roentgenol， 1983; 141(4)∶ 653.
- 7. Heuck A, Maubach PA, Reiser M, et al. Age-related morphology of the normal pancreas on computed tomography [J]. Gastrointest Radiol， 1987; 12(1)∶ 18.
- 8. Patel S, Bellon EM, Haaga J, et al. Fat replacement of the exocrine pancreas [J]. AJR Am J Roentgenol， 1980; 135(4)∶ 843.
- 9. Matsumoto S, Mori H, Miyake H, et al. Uneven fatty replacement of the pancreas: evaluation with CT [J]. Radiology， 1995; 194(2)∶ 453.
- 10. Li Y, Cao L, Wang BZ, et al. The structural change of pancreatic tissue of fatty rats induced with high-fat food and its pathological significance [J]. Chin J Histochem Cytochem, 2004； 13(3)∶ 353.
- 11. Katz DS, Nardi PM, Hines J, et al. Lipomas of the pancreas [J]. AJR Am J Roentgenol, 1998; 170(6)∶1485.
