急性坏死性胰腺炎的CT征象及其临床意义

CT Image of Acutic Necrosis Pancreatitis and Its Clinical Significance

目的:研究急性坏死性胰腺炎的CT 表现和临床意义。材料和方法:回顾了早期(48 小时内) 经CT 检查并经多次CT 随访的坏死性胰腺炎,临床和血尿淀粉酶均符合的50 例患者,平扫及团注法增强扫描,观察胰腺密度、体积、包膜改变,积液范围及程度,特别注意了脾出血和脾血管受侵的危重征象。结果:急性坏死性胰腺炎早期CT 图像均能做出明确诊断。多部位胰腺坏死及胰周积液超过2 个部位以上是产生并发症和临床预后较差的指征。结论:在坏死性胰腺炎诊断中CT 是最直观和显示受侵部位最清晰的影像手段,早期CT 扫描,适时CT 随访是估价临床预后有力依据之一,脾血管受侵是引起死亡的重要并发症。

Purpose:To study the relationship hetween the imaging of CT and the prognosis of acutic necrosis pancreatitis. Materials and Methodes:50 cases of acutic necrosis pancreatitis with CT scan were studied retrospectively. The initial examination was in 48 hours when the patient had a typical pancreatitis symptom and arising of the amylopsin and amylasuria. By using the plain scan and a rapid bolus injection enhanced scan, we have studied the density of pancreace, the volume, the capsule change, the range and degree of effusion, especially by the hemorrhage of spleen and the invasion of spleen vessels. Results:The early diagnosis of acutic necrosis panecreatitis was defined by CT. Multi places necrosis and more than two place of peripancreatic effusion suggeste the complication and the worse prognose would be. Conclusion:CT examination is a methods in the diagnosis of the acutic necrosis pancreatitis which can provide the most audio visual and the distinctest showing the invasion place. The initial CT scan and the reexamination is one of the most dependent basis in estimate the prognose. The invasion of spleen vessels is the important complication which is causing fatality.