胰腺损伤的影像学诊断

Imaging diagnosis of pancreatic injury

目的探讨多层螺旋CT及MRI检查在评价胰腺损伤中的价值。方法回顾性分析经手术和临床随访证实的10例闭合性腹部外伤致胰腺损伤的CT/MRI表现。男6例,女4例,年龄5-52岁,平均年龄（27.60±12.34）岁。CT检查7例,MRI检查5例,其中2例分别进行了CT和MRI检查。结果胰腺损伤CT/MRI表现为：胰腺肿大（CT5例,MR2例）;胰腺断裂（CT5例,MR4例）;主胰管断裂（CT1例,MR4例）;胰腺内/胰周出血（CT3例,MR1例）;胰腺裂伤（CT2例,MR1例）;胰周改变：胰周被膜和肾周筋膜增厚以及胰周、肾旁间隙广泛积液（CT6例,MR5例）;假性囊肿形成（CT4例,MR2例）;合并腹部其他脏器损伤：CT显示肝、肾损伤各1例,脾损伤2例,MR显示脾损伤1例。结论多层螺旋CT和MRI在胰腺损伤的诊断中有重要价值。

Objective To study the value of MSCT and MRI examination in pancreatic injury. Methods It was analyzed retrospectively that the CT and MRI features of 10 patients with pancreatic injury caused by closed abdominal trauma confirmed by surgery and clinic observation. They were 6 males and 4 females with an average age of （27.60± 12. 34） years old, ranging from 5 to 52 years old. Seven cases were examinated by MSCT, and 5 cases by MRI,in which 2 cases by both MSCT and MRI. Results The features of pancreatic injury on MSCT/MR images included： pancreas enlargement （5 cases on CT, 2 cases on MR） ; pancreatic rupture （CT in 5 cases, MR in 4 cases） ; the main pancreatic duct rupture （CT in 1 case, MR in 4 cases） ; pancreatic and peri-pancreatic hematoma （CT in 3 cases, MR in 1 case） ; pancreatic laceration （CT in 2 cases, MR in 1 case） ; peripancreatic abnormalities （CT in 6 cases, MR in 5 cases） ; thickening of pancreatic and renal facial, fluid collected in peri-pancreas and peri-renal space, peripancreatic pseudocyst （CT in 4 cases, MR in 2 cases）; merging the contusion of liver, kidney or spleen into pancreatic injury were found （CT for liver and kidney in 1 case, for spleen in 2 cases, MR for spleen in 1 case）. Conclusion MSCT and MRI have important value in the diagnosis of pancreatic injury.