目的    从误诊为胰腺癌病例中寻找胰腺炎的影像特征。 方法    回顾性分析2001-2010年第二军医大学附属长征医院22例误诊为胰腺癌的胰腺炎CT、MRI影像学资料。 结果    误为局限性胰腺癌的胰腺炎有5种表现：胰腺局限性增大，胰腺内坏死、假性囊肿，胰腺不均匀脂肪沉积，继发于胰腺分裂的胰管潴留性扩张或胰管积血。误为弥漫性胰腺癌的胰腺炎有3种表现：胰腺弥漫肿大，胰腺广泛乏血供病变，胰腺周围没有渗出。误为胰腺外转移的胰腺炎有2种表现：胰旁假性囊肿、炎性结节误认为转移淋巴结，局部静脉血栓、动脉狭窄误认为血管侵犯。 结论    对表现不典型的胰腺癌均应想到胰腺炎或合并胰腺炎可能，应完整了解病史，仔细分析影像学特点和变化规律，密切随访。

CT and MRI manifestations of pancreatitis misdiagnosed as pancreatic cancer        SU Tao*，WANG Jian，JIN Han-tao，et al. *Department of Emergency，Center Hospital of Xuhui District，Shanghai 200031，China
Corresponding author : WANG Jian ，E-mail：wangjian_su@yahoo.com.cn
Abstract    Objective    To research the key points in differential diagnosis of pancreatitis and pancreatic cancer. Methods    The imaging data of 22 cases of pancreatitis misdiagnosed as pancreatic cancer between 2001 and 2010 at Changzheng Hospital Affiliated to the Second Military Medical University were analyzed retrospectively. Results Manifestations of pancreatitis misdiagnosed as localized pancreatic cancer were pseudotumorous pancreatitis of pancreatic head or pancreatic body；pancreatic necrosis and pseudocyst；inhomogeneous lipidosis；retentive extension of pancreatic duct due to pancreas divisum and accumulation of blood in pancreatic duct due to pancreas divisum. Misdiagnosed as disseminated pancreatic cancer were disseminated enlargement of pancreas with inhomogeneous density, lesser blood supply lesion and pancreatitis without effusion. Misdiagnosed as metastases outside pancreas were parapancreatic pseudocysts or inflammatory mass misdiagnosed as metastatic lymph nodes. Accessory lesions of superior mesenteric vein and splenic vein misdiagnosed as vascular invasions. Conclusion    Diagnosis of atypical pancreatic cancer should be based on a comprehensive knowledge of medical history and weekly follow-ups so as to exclude the possibility of atypical pancreatitis. As for patients who have both pancreatitis and pancreatic cancer，treatments of pancreatitis with therapeutic values should always be emphasized regardless of the pancreatic cancer.