新亚特兰大标准下急性坏死性胰腺炎的CT/MRI评价

CT/MRI Evaluation of Acute Necrotizing Pancreatitis According to New Atlanta Criteria

在急性胰腺炎(AP)2012年亚特兰大分类中,AP分为急性间质水肿型胰腺炎(AIEP)和急性坏死性胰腺炎(ANP),而ANP又分为三种类型:独立胰腺坏死型,独立胰周坏死型和共同坏死型。ANP促进器官功能衰竭的发展,死亡率远远高于AIEP,因此ANP有着重要的临床意义。不同类型和程度的ANP有着不同的临床病程和预后。影像学检查在ANP评价中有着举足轻重的作用,其可直观地反映ANP的类型和坏死的程度。CT是评价AP的首选检查手段,但近年来MRI在AP的应用越来越普遍。本文就新亚特兰大标准下ANP的CT/MRI评价做一图文综述,并探讨了目前存在的问题,并对未来发展进行了展望。

In the revised Atlanta classification (RAC), acute pancreatitis is classified into acute interstitial edematous pancreatitis (AIEP) and acute necrotic pancreatitis (ANP), and the ANP is classified into three types: pancreatic necrosis (PN) alone, peripancreatic necrosis (PPN) alone and combined necrosis. ANP can promote the development of organ failure and its mortality is greatly higher than AIEP. Thus, ANP has great clinical importance. Different types and extent of ANP have different prognosis. Radiologic examinations play an important role in evaluating ANP, for example, it can directly reflect the type of ANP and the extent of necrosis. CT is a primary tool for the detection of AP, whereas in recent years MRI has increasingly used in AP. This article summaries the performances of CT/MRI in evaluation of ANP based on the RAC, either of the type or the extent, and also discuss the existent problems and expect the development of the future.