胆源性急性胰腺炎合并肝脏异常灌注的CT评价

The CT evaluation of biliary acute pancreatitis combined with hepatic abnormal perfusion

目的应用CT评价胆源性急性胰腺炎合并肝脏异常灌注(HAP)的发生率、形态、分布及相关机制。方法 32例胆源性急性胰腺炎患者接受上腹部CT增强扫描,分析HAP的发生率、形态、分布。将胆源性急性胰腺炎患者分为HAP阳性组和HAP阴性组,分析两组胆源性急性胰腺炎的胆道系统异常CT征象,比较两组间胆道系统异常CT征象出现率的差异。结果 32例胆源性急性胰腺炎中,11例(34.4%)出现HAP,CT影像表现为邻近胆囊的肝组织条带状异常强化,肝左叶或肝右叶斑片状或楔形异常灌注。HAP阳性组与HAP阴性组间胆道系统异常CT征象出现率差异无统计学意义(χ2=1.60,P>0.05)。结论胆源性急性胰腺炎合并HAP可能是由于急性胰腺炎本身炎症扩散和胆源性因素相互共同作用导致。

Objective To evaluate the prevalence,shape,distribution and relative mechanisms of biliary acute pancreatitis（ AP） combined with hepatic abnormal perfusion（ HAP） by CT.Methods Thirty-two patients with biliary AP received an enhanced abdominal CT and the prevalence,shape and distribution of HAP on CT were analyzed.These patients were divided into HAP positive and HAP negative groups.The biliary system abnormal CT signs were analyzed and the difference in the prevalence of biliary system abnormal CT signs was compared between the two groups.Results In the 32 patients with biliary AP,11 patients（ 34. 4%） showed HAP,including strip-,wedge- or patch-shaped HAP distributed in the hepatic tissue adjacent to the gallbladder and left and right liver lobes on CT.There were no significant difference in the prevalence of biliary system abnormal CT signs between the two groups（ χ2= 1. 60,P〉 0. 05）.Conclusion HAP is common in patients with biliary AP.HAP is caused by both the spread of inflammatory changes of AP and biliary factors.