MSCT灌注成像参数在重症急性胰腺炎临床诊治中的应用价值

Application Value of Perfusion Imaging Parameters of MSCT in the Clinical Diagnosis of Severe Acute Pancreatitis

目的分析多层螺旋CT(MSCT)灌注成像参数在重症急性胰腺炎(SAP)临床诊治中的应用价值。方法选取本院2016年4月至2019年10月收治且经手术病理或生化指标检测确诊的92例AP患者作为研究对象。其中SAP患者31例,轻症急性胰腺炎(MAP)患者61例。同期选取本院接受健康体检的36例体检者作为对照组。比较不同组别患者的MSCT灌注成像参数及MSCT诊断SAP的敏感性、特异性及准确性。结果SAP组患者的血流量(BF)、平均通过时间(MTT)及血容量(BV)数值均显著低于MAP组和对照组,表面渗透系数(PS)数值高于对照组和MAP组;MAP组患者BF、BV及MTT数值均高于SAP组和对照组,PS数值高于对照组,低于SAP组。三组患者BF、BV、PS数值比较,差异具有统计学意义(P<0.05),MTT值比较无明显差异(P>0.05)。以病理诊断结果为“金标准”,MSCT灌注成像鉴别诊断SAP的敏感性、特异性及准确性分别为90.32%(28/31)、93.44%(57/61)、92.39%(85/92)。结论MSCT灌注成像可有效反映SAP的血流动力学变化,诊断准确率较高,在诊断和指导临床治疗上具有一定的应用价值。

Objective To analyze the application value of perfusion imaging parameters of multi-slice spiral CT(MSCT)in the clinical diagnosis of severe acute pancreatitis(SAP).Methods 92 patients with AP admitted to our hospital from April 2016 to October 2019 and confirmed by surgical pathology or biochemical indicators were selected as the research subjects.There were 31 patients with SAP and 61 patients with mild acute pancreatitis(MAP).In the same period,36 patients who underwent a physical examination in our hospital were selected as the control group.The MSCT perfusion imaging parameters between different groups and the sensitivity,specificity and accuracy of MSCT in the diagnosis of SAP were compared.Results The blood flow(BF),mean transit time(MTT),and blood volume(BV)values of the SAP group were significantly lower than those of the MAP group and the control group,and the values of surface permeability coefficient(PS)were higher than those of the control group and the MAP group.The values of BF,BV,and MTT in the MAP group were higher than those in the SAP group and the control group,and the PS value was higher that in the control group and lower than that in the SAP group.The differences in the BF,BV,and PS values between the three groups were statistically significant(P<0.05),and in the MTT value was not significantly different(P>0.05).The result of pathological diagnosis was the gold standard.The sensitivity,specificity,and accuracy of MSCT perfusion imaging in the differential diagnosis of SAP were 90.32%(28/31),93.44%(57/61),and 92.39%(85/92).Conclusion MSCT perfusion imaging can effectively reflect the hemodynamic changes of SAP,and has a higher diagnostic accuracy.It has some application value in diagnosis and guidance of clinical treatment.