多排螺旋CT扫描对急性胰腺炎及其严重性评价的临床应用

Clinical Application of Muitislice Spiral Computed Tomography Scan in the Diagnosis and Severity Evaluation of Acute Pancreatitis

[目的]回顾性分析急性胰腺炎（AP）的CT影像学特征,探讨多排螺旋CT扫描技术及重建技术对AP及其严重性评价的诊断价值.[方法]93例均经过MSCT 检查诊断AP并且得到手术病理或临床证实的病例,平均年龄47（16-83）岁,男性50例,女性37例,CT 双期薄层扫描并针对性进行重建,根据影像学和临床分型分级,评分,确定严重程度.[结果]出现胰腺体积增大,胰周脂肪间隙模糊或积液,肾前筋膜增厚达85%以上,为CT基本征象,40例CT分级A 级、B 级或C 级,CTSI严重度分级Ⅰ度诊断为轻型AP（MAP）;53例CT分级D级或E级,CTSI 严重度分级Ⅱ度、Ⅲ度,诊断为SAP.[结论]多排螺旋CT 扫描及重建能清晰显示AP的出血、坏死范围及其并发症,从而可对AP严重程度进行评价,对指导临床诊断和治疗具有重要价值.

[Objective] To retrospectively analyze the CT manifestations in acute pancreatitis（AP） patients, and investigate the value of multislice spiral computed tomography（MSCT） and image reconstruction technique in the diagnosis and severity evaluation of AP. [Methods] Ninety three patients（50 males and 37 females, aged from 16-83 years with the average of 47 years） who had been diagnosed as AP after MSCT scanning and pathologically or clinically proved were collected. Dual-phase and thin-slice MSCT scanning as well as reconstructive imaging technique were performed in all these 93 patients. [Results] Three basic CT findings including enlargement of pancreas, peripancreatic space blurring or fluid and thickened renal fascia were detected in 85~/~ patients. According to the CT findings, 40 patients were categorized into grade A, B, and C and CT2SI grade Ⅰ, which was indicative of MAP, while 53 patients were categorized into grade D, E and CT2SI grade Ⅱ or Ⅲ, which was indicative of SAP. [Conclusion] MSCT scanning and image reconstruction can clearly indicate the intensity of hemorrhage and necrosis as well as the occurrence of related complications, so it is of great value in clinical diagnosis and treatment of AP.