CT严重指数、Ransons评分及超声造影严重指数评估急性胰腺炎病情

Contrast-enhanced ultrasound severity index vs CTSI and Ranson’s score for evaluation of severity of acute pancreatitis

背景常规超声在急性胰腺炎(acute pancreatitis,AP)病情判断中较为重要,但对胰腺坏死病灶的判断较为困难.超声造影能敏感显示胰腺组织的微循环灌注状态,实时反映胰腺组织的缺血坏死区域,有助于提高超声诊断重症AP的准确率.目的运用超声造影评估AP病情,探讨超声造影严重指数(ultrasound severity indices,USSI)与CT严重指数(CT severity indices,CTSI)、Ransons评分的相关性.方法选取我院收治的67例AP患者作为研究对象.所有患者入院3d内行胰腺增强CT和超声造影检查,记录CTSI、USSI,并行Ransons评分,分析USSI与CTSI、Ransons评分的相关性.结果超声造影对胰腺坏死灶的检出率为93.81%;超声造影判定重型AP的敏感度=88.46%、特异度=95.12%、准确度=92.54%;重型AP患者的USSI、CTSI、Ransons评分明显高于轻型A P患者,差异有统计学意义(P<0.05);USSI与CTSI呈正相关(r=0.95,P<0.05);USSI与Ransons评分呈正相关(r=0.75,P<0.05).结论超声造影能有效发现AP坏死灶,准确评估AP严重程度,其USSI与CTSI、Ransons评分相关性良好,可为临床评估病情及预后提供参考.

BACKGROUND Conventional ultrasound is important in the diagnosis of acute pancreatitis(AP),but it is difficult to judge pancreatic necrosis.Contrast-enhanced ultrasound(CEUS)can sensitively display the microcirculation state of pancreatic tissue and reflect the pancreatic necrosis in real time,which is helpful to improve the accuracy of ultrasonography in the diagnosis of severe AP.AIM To evaluate the severity of AP by CEUS,and to explore the correlation of contrast-enhanced ultrasound severity index(USSI)with CT severity index(CTSI)and Ranson’s score.METHODS Sixty-seven patients with AP treated at our hospital were selected as the research subjects.All patients underwent enhanced CT and CEUS within 3 d after admission.CTSI,USSI,and Ranson’s score were recorded.The correlation of USSI with CTSI and Ranson’s score was analyzed.RESULTS The detection rate of pancreatic necrosis by CEUS was 93.81%.The sensitivity,specificity,and accuracy of CEUS in the diagnosis of severe AP were 88.46%,95.12%,and 92.54%,respectively.The USSI,CTSI,and Ranson’s score of severe AP patients were significantly higher than those of mild AP patients(P<0.05).USSI was positively correlated with CTSI(r=0.95,P<0.05)and Ranson’s score(r=0.75,P<0.05).CONCLUSION CEUS can effectively detect AP necrosis and accurately assess the severity of AP.USSI has a good correlation with CTSI and Ranson’s score,which can provide reference for clinical evaluation of disease condition and prognosis.