急性胰腺炎累及肠系膜与其肠管的CT表现及临床相关性

The Clinical Correlation and CT Characteristics of Mesentery and Small Intestine Involvement in Acute Pancreatitis

目的分析急性胰腺炎(AP)累及肠系膜与其肠管的CT表现及临床相关性。资料与方法回顾性分析64例经临床和实验室检查证实为AP的临床与CT资料,分析肠系膜与其肠管受累的CT表现及其临床相关性。结果本组64例患者中,肠系膜受累18例(28.1%),表现为小肠系膜或其根部水肿、密度增高,其内脂肪见絮状影;肠系膜相应肠管受累5例(7.8%),表现为肠壁增厚或肠管积气、积液;轻症AP发生率为32.8%(21/64),重症AP发生率为67.2%(43/64),重症AP中以小肠系膜受累的发生率最高(27.9%,12/43)。肠系膜与其肠管受累的CT形态评分与AP严重程度呈正相关(r=0.243,P<0.05)。结论 AP肠系膜与其肠管受累能在一定程度上反映AP的严重程度。掌握AP肠系膜与其肠管受累的CT表现,可为临床判断AP病情及制定对症治疗方案提供有力依据。

Purpose To investigate the CT characteristics and clinical correlation of mesentery and small intestine involvement in acute pancreatitis （AP）. Materials and Methods CT images in 64 patients with AP confirmed by clinical and laboratory examination were retrospectively analyzed, and the CT characteristics of mesentery and small intestine involvement and the relationship with AP severity were also investigated. Results Mesentery involvement was found in 18 out 64 patients （28.1%）, showing edema at the mesentery or its roots; hyperdense and flocculent morphology within adipose tissue. Small intestine involvement accounted for 7.8% （5/64）, showing wall thickening or gas/fluid accumulation. There were 21 mild AP （32.8%） and 43 severe AP （67.2%）. The incidence of mesentery-intestine involvement in severe cases was 27.9% （12/43）. CT appearance grading of mesentery-intestine involvement had positive correlation with clinical severity grading ofAP （r = 0.243, P 〈 0.05）. Conclusion AP mesentery and small intestine involvement in AP is related to the severity of AP. The CT features can help with AP management.