CT增强薄层扫描在重症胰腺炎中的诊治价值

VALUE OF THIN SLICE CT CONTRAST-ENHANCED SCANNING IN THE DIAGNOSIS AND TREATMENT OF ACUTE SEVERE PANCREATITIS

目的 :探讨CT增强薄层扫描在重症胰腺炎诊治中的价值。方法 :对 48例经手术病理证实或CT复查确诊的急性重症胰腺炎进行回顾性分析。全部病例采用CT平扫 +增强扫描 ,增强时在胰腺区行薄层 (层厚 3～ 5mm ,间距 3～ 5mm)扫描 ,并对其中 32例行重复CT动态扫描。结果 :CT平扫能确定坏死灶 12例 ,占 2 5 %。其中 8例于增强薄层扫描中 ,显示坏死灶数量增多范围扩大。全部 48例经增强薄层扫描均清楚显示坏死数量、范围和胰周情况。结论 :CT增强薄层扫描加上动态观察 ,能明确胰腺炎坏死的部位、范围程度和胰周病理改变 ,对CT分级、病理变化。

Objective:To judge the value of thin slice CT contrast-enhanced scanning in the Diagnosis and treatment of acute severe pancreatitis. Methods: 48 cases of acute severe pancreatitis confirmed by operation, pathology or CT reexamination were reviewed. Nonenhanced and contrast-enhanced CT scan of the said patients were performed. and complemented with thin slice CT contrast - enhanced scan in the pancresa areas (thickess 3-5mm, Interval 3-5mm). 32 cases were reexamined with dynamic CT scanning. Result:12 cases(25%) underwent CT plain showed the lessions of necroses. All patients complemented with thin slice CT contrast-enhanced scanning accurately displayed location, extent, degree of the pancreatic necrothing lesion, and peripancreatic pathological changes. The relatons of clinic gracling, CT rading and CT severity classificafion to prognosis, and the dynamic changes were discussed in this paper. Conclusion: The thin slice CT contrast-enhanced scanning and dynamic observation could accurately show location, extent, degree of the necroting pancreatitis and peripancreatic pathological changes. It is of clinical significance to CT classifications, pathological changes, the treatments, and the prognosis of the patients.