超声、CT检查对急性胰腺炎诊断及临床治疗的辅助作用研究

Diagnostic Efficacy of Ultrasound and CT Examination for Acute Pancreatitis and the Auxiliary Role of Clinical Treatment

目的探讨超声、CT检查对急性胰腺炎的诊断及临床治疗的辅助作用。方法选取本院2017年8月至2019年7月收治的87例急性胰腺炎患者的临床资料,所有患者均进行超声和CT检查,对患者影像学表现进行分析,以手术检查结果为基准比较超声、CT检查对急性胰腺炎的诊断正确率,以及对胰管扩张、实质不均匀、脂肪层模糊不清、胰外脓肿、胆总管结石等情况检出率进行比较。结果超声对急性胰腺炎检出率为79.31%,明显低于CT检查(94.25%)(P<0.05)。CT检查对胰胆管扩张、实质不均匀、脂肪层模糊不清、局限性扩大、胆总管结石检出率明显优于超声检查(P<0.05);胰外脓肿局限性扩大检出率上两者比较差异无统计学意义(P>0.05)。急性胰腺炎患者症状较重患者,CT图像可见胰腺体积明显增大,密度不均边缘规则,有出血灶、液化坏死区,肾前筋膜有明显增厚,胰周有积液;轻症胰腺炎CT图像仅出现胰腺密度及体积增大,边缘毛糙,胰周积液少,无坏死区。结论CT检查对急性胰腺诊断明显优于超声检查,可对急性胰腺炎并发症、预后以及坏死情况作出评价,对临床治疗有较高的辅助价值。

Objective To explore the diagnostic efficacy of ultrasound and CT examination for acute pancreatitis and the auxiliary role of clinical treatment.Methods The clinical data of 87 patients with acute pancreatitis admitted to our hospital from August 2017 to July 2019 were selected.All patients underwent ultrasound and CT examinations.The imaging characteristics of the patients were analyzed,and the results of the surgical examination were used as benchmark to compare the diagnostic accuracy of ultrasound and CT examination for acute pancreatitis,and to compare the detection rates for pancreatic duct dilatation,parenchymal unevenness,obscure fat layer,extrapancreatic abscess,and choledocholithiasis.Results The detection rate of ultrasound for acute pancreatitis was 79.31%,which was significantly lower than that of CT(94.25%)(P<0.05).The detection rates of ultrasound for pancreatic duct dilatation,parenchymal unevenness,obscure fat layer,limited enlargement of fat layer,extrapancreatic abscess,and choledocholithiasis were significantly better than those of ultrasonography(P<0.05).There was no significant difference in the detection rate of extrapancreatic abscess between them(P>0.05).For patients with severe symptoms of acute pancreatitis,CT images showed significant increasing of pancreatic volume,uneven density,regular margins,hemorrhagic foci,liquefied necrotic area,thickening of the prerenal fascia,effusion around the pancreas.For patients with mild pancreatitis,CT images only showed increasing of pancreatic density and volume,with rough edges,less peripancreatic effusion,and no necrotic areas.Conclusion CT examination is superior to ultrasonography in the diagnosis of acute pancreas.It can evaluate the complications,prognosis and necrosis of acute pancreatitis,and has a high auxiliary value for clinical treatment.