64层螺旋CT在急性胰腺炎诊断中的临床应用

THE CLINICAL APPLICATION OF 64-SLICE SPIRAL CT IN THE DIAGNOSIS OF ACUTE PANCREATITIS

目的探讨64层螺旋CT在急性胰腺炎(AP)诊断中的临床应用价值。方法选取2015年1月—2016年6月的100例急性胰腺炎患者,按照《急性胰腺炎诊治指南(2014)》分为二组:急性间质水肿型胰腺炎50例和急性坏死胰腺炎50例。对所有患者采用64层螺旋CT、病理学检查,比较二种方法对胰腺炎的诊断准确率,并比较二组患者CT灌注成像参数值情况,对各灌注参数与AP病情严重程度相关性进行分析。结果 64层螺旋CT对胰腺炎的诊断准确率高达97.00%,二组的灌注参数TTP、PS差异无统计学意义(P>0.05),急性间质水肿组的灌注参数BF和BV明显高于急性坏死组(P<0.05);患者的灌注参数BF、BV均与病情严重程度指标APACHEⅡ评分、Ranson评分呈负相关(P<0.05),灌注参数TTP、PS与APACHEⅡ评分、Ranson评分无相关性(P>0.05)。结论 64层螺旋CT检查对急性胰腺炎诊断准确率高,并对胰腺组织破坏及微循环障碍程度定量评价,具有较高的临床应用价值。

Objective To explore the clinical value of 64-slice spiral CT in the diagnosis of acute pancreatitis（AP）.Methods According to＇Guidelines for Diagnosis and Treatment of Acute Pancreatitis（2014）＇,100 patients with acute pancreatitis from January2015 to June 2016 were divided into two groups：acute interstitial edematous pancreatitis in50 cases and acute necrotizing pancreatitis in50 cases.All patients were examined by 64-slice spiral CT and pathology.The diagnostic accuracy of pancreatitis was compared between the two methods.CT perfusion imaging parameters were compared between the two groups.The correlation between perfusion parameters and the severity of AP was analyzed.Results 64-slice spiral CT in the diagnosis of pancreatitis was as high as 97.00% accuracy,and there were no significant differences in the parameters of perfusion TTP and PS between the two groups（P〉0.05）;BF and BV of acute interstitial edema group were significantly higher than those of acute necrosis group（P〈0.05）.The perfusion parameters BF,BV were negatively correlated with APACHE Ⅱ score and Ranson score（P〈0.05）,and there was no correlation between perfusion parameters TTP,PS and APACHE Ⅱ score and Ranson score（P〉0.05）.Conclusion 64-slice spiral CT shows a high accuracy on the diagnosis of acute pancreatitis,and it is also a high clinical quantitative evaluation method for pancreatic tissue damage and microcirculation disturbance degree.