探讨胰周征象在急性胰腺炎超声诊断中的价值

To investigate the value of peripancreatic signs in ultrasonic diagnosis of acute pancreatitis

目的:寻找胰周征象中诊断急性胰腺炎(AP)的最佳征象。方法:2015年11月-2017年11月收治AP患者50例,记录胰腺改变及胰周改变的超声表现,寻找早期诊断胰腺炎的超声征象中最有价值的胰周征象。结果:50例患者中,胰腺腺体阳性改变37例(74%),其中胰腺体积增大27例(54%),表面毛糙17例(34%),回声有改变23例(46%),胰管扩张7例(14%);胰周阳性改变47例(94%),其中网膜阳性表现42例(84%),胰外积液26例(52%)。结论:胰周超声改变较胰腺超声改变对AP诊断价值更大,一旦发现网膜病变、胰周积液,尤其是对于胰腺显示不清或胰腺尚无明显改变的AP诊断具有重要临床意义。

Objective:To search for the best sign of peripancreatic signs in diagnosis of acute pancreatitis(AP).Methods:From November 2015 to November 2017,50 AP patients were selected,we recorded the ultrasonic manifestations of pancreatic changes and peripancreatic changes,and looked for the most valuable peripancreatic signs of early diagnosis of pancreatitis.Results:Among the 50 patients,37 cases(74%)had positive changes in pancreatic glands,including 27 cases(54%)with enlarged pancreatic volume,17 cases(34%)with rough surface,23 cases(46%)with echo change and 7 cases(14%)with pancreatic duct dilatation;There were 47 cases(94%)of peripancreatic positive changes,including 42 cases(84%)of positive findings of omentum and 26 cases(52%)of extrapancreatic effusion.Conclusion:The value of ultrasound changes around pancreas in the diagnosis of AP is greater than that of ultrasonic changes of pancreas,once omental lesions and peripancreatic effusion are found,it is of great clinical significance to diagnose AP if the pancreas is not clearly displayed or the pancreas has no obvious changes.