CT分级诊断在急性胰腺炎临床治疗中的价值

Value of CT Grading Diagnosis in Clinical Therapy of Acute Pancreatitis

目的探讨CT分级诊断对急性胰腺炎临床治疗的价值。方法 2003～2009年期间在四川省广汉市人民医院确诊的急性胰腺炎患者518例,均进行CT扫描,除有造影剂禁忌证者行平扫外,均行增强扫描。2名放射科医师分析图像,对疾病严重程度进行CT分级,并与临床分级及治疗预后进行对比研究。结果 518例中,CT分级情况为:A级9例、B级66例、C级105例、D级147例和E级191例。A、B级病例均经保守支持治疗后痊愈;C级病例中,保守治疗后除2例病情有反复外,其余均痊愈;94例手术病例及23例死亡病例均发生在D级及E级中。结论急性胰腺炎CT分级能直观反映病变范围、程度及病程变化,与临床严重程度分级相关性好。

Objective To investigate the value of CT grading diagnosis in clinical therapy of acute pancreatitis.Methods CT scanning was carried out in patients with acute pancreatitis between 2003 and 2009,and Enhancement CT scanning was carried out in patients without contraindications of contrast medium.Two radiologists analyzed the images and made CT grading diagnose.Contrast study was made between CT grading diagnose and clinical scale as well as prognosis.Results In 518 cases,the CT grading was as the following： grade A 9 cases,grade B 66 cases,grade C 105 cases,grade D 147 cases,and grade E 191 cases.Patients with grade A and B were fully recovered after conservation and supportive treatment.In cases of grade C,only 2 patients had recurred pancreatitis after conservation treatment,and others were fully healing.Ninety-four patients who needed operation and 23 patients who died were all occurred in grade D and E.Conclusion CT grading diagnosis of acute pancreatitis can reflect the range,extent,and course of disease,and it has good dependablity with clinical grading.