急性胰腺炎预后的CT研究进展

Outcome assessment of acute pancreatitis with computed tomography

急性胰腺炎(AP)早期是诊断与治疗的关键时期,早期影像诊断可对预后进行推测并判断一些重要并发症出现的可能性。目前,CT检查为早期AP最重要的影像检查技术,已建立多种评分系统进行AP严重度的评估,其中应用最广泛的是CT严重度指数(CTSI)及修订的CTSI(MCTSI)。CT评分可较好地预测预后,甚至判断是否出现器官衰竭。CECT所见的低强化及CTP显示的灌注减低是预示胰腺梗死的较好指标,但CT难以预测AP是否出现血管并发症及合并感染。

Early phase of acute pancreatitis （AP） is critical for its diagnosis and treatment, including prediction of outcome and some important complications based on the early imaging findings. So far, CT has become the most important imaging technique for evaluating AP. Multiple CT score systems have been developed for assessment the severity of AP. CTSI （computed tomography severity index） and MCTSI （modified computed tomography severity index） are the most favorite ones. CT score index can be used to predict the prognosis of AP, even the occurence of organ failure. The hypo-enhancement on CECT and hypo-perfusion on CTP indicate pancreatic necrosis. However, vascular complications and secondary infection of AP could not be predicted accurately with CT data.