急性胰腺炎累及盆部腹膜外间隙的螺旋CT表现

Pelvic extraperitoneal space involvement in acute pancreatitis under spiral CT

目的探讨急性胰腺炎(AP)扩散至盆外间隙的CT表现及其临床价值。方法分析87例AP患者螺旋CT表现,着重观察AP扩散至盆外间隙的CT表现特征。结果AP所致腹膜后间隙积液蔓延至盆外间隙的发生率为34·5%(30/87)。盆外间隙积液的CT表现主要有4种类型。若以AP扩散至盆外间隙作为判断重症AP的阳性标准,其敏感度47·6%(30/63),特异度100%(24/24),阳性预测值100%(30/30),阴性预测值42·1%(24/57),准确度62%(54/87)。结论急性胰腺炎所致的盆外间隙积液有4种表现形式,盆外间隙积液是判断急性重症胰腺炎简单而特异度高的指标。

Objective To explore the characteristics of pancreatitic fluid under spiral CT, which pervades to the pelvic extrapefitoneal space （PES）. Methods The CT images of 87 patients with AP were retrospectively analyzed by two experienced abdominal radiologists, especially the manifestation of AP-fluid pervasion to PES. Results AP fluid pervasion to the PES was found in 30 patients （34.5%, 30/87）. If AP fluid pervasion to the PES served as an index in judging severe AP, the sensitivity was 47.5% , specificity 100%, positive predictive value 100% , negative predictive value 42.1% and accuracy rate 62 % . Conclusion Fluid in the PES could serve as an inedx in judging severe AP. Fluid of AP in the PES has four types.