急性胰腺炎累及桥隔的CT表现及其临床意义

CT manifestations of acute pancreatitis involving the bridging septa and its correlation with EPICT

目的讨急性胰腺炎(AP)时肾周间隙内桥隔(BSPS)受累的CT表现及其与胰腺外炎症CT(EPICT)评分的相关性。方法收集106例行全腹CT扫描的AP患者的资料并进行回顾性分析,着重研究双侧BSPS的改变,并记录相应AP患者的EPICT的分值。结果 (1)39例患者的EPICT评分的分值为0~3,67例为4~7分。所有患者均有一侧和/或两侧BSPS受累。左侧BSPS增厚102例,BSPS积液47例;右侧BSPS增厚98例,BSPS积液38例;(2)BSPS增厚表现为走行紊乱的呈稍高密度的条索影,其边缘模糊;BSPS积液表现为与增厚的BSPS走行相一致的边缘模糊的液性密度影;(3)急性胰腺炎所致的BSPS改变与其EPICT评分呈现相关性(r=0.703,P<0.01)。结论 CT可充分显示急性胰腺炎侵犯BSPS的情况;其表现可反映急性胰腺炎的临床严重程度。

Objective To study the computed tomography （CT） manifestations of involvement of bridging septa in the perirenal space （BSPS） during acute pancreatitis （AP） and its correlation with extrapancreatie inflammation on abdominal computed tomography （EPICT） score. Methods 106 patients with acute pancreatitis were ineluded in this study. Emphasis was placed on CT findings of BSPS and the EPICT score in all the patients. Results The EPICT score was 4 to 7 in 67 patients, and the EPICT score was 0 to 3 in 39 patients. BSPS involvement was shown in all the patients. The left or right BSPS involved in 102 patients and 98 patients, respectively. Thickening of the BSPS was shown as strip shadow with slightly higher density and hazy border ; fluid collection of the BSPS was shown as liquid density with hazy border. The involvement of BSPS showed a statistically significant association with the EPICT score in the AP patients （r = 0. 703, P 〈 0.01 ）. Conclusion BSPS involved by acute pancreatitis is shown as a strip shadow with slightly higher density or as liquid density with hazy border on CT images, reflecting the severity of the acute pancreatitis.