胰腺MSCT灌注扫描参数对鉴别重症急性胰腺炎并发胰周感染的价值

Value of pancreatic MSCT perfusion scan parameters in identifying severe acute pancreatitis complicated with peripancreatic infection

目的分析多层螺旋计算机断层扫描(MSCT)灌注扫描对鉴别老年重症急性胰腺炎患者是否并发胰周感染的价值。方法对我院收治的110例重症急性胰腺炎患者实施MSCT灌注扫描,对患者进行影像学特征与病情转归情况分析;对比并发胰周感染的患者和未并发患者MSCT灌注扫描参数,绘制受试者工作特征(ROC)曲线评估MSCT灌注扫描参数对胰周感染的价值。结果入选患者中有23例并发胰周感染,发生率为20.91%,病死率为0.91%;并发胰周感染的患者与未并发患者性别、年龄比较差异均无统计学意义(P>0.05),并发胰周感染的患者APACHEⅡ评分高于未并发患者(P<0.05);并发胰周感染的患者达峰时间长于未并发患者,峰值高度低于未并发患者,血流量少于未并发患者,差异均有统计学意义(P<0.05);ROC曲线分析显示,达峰时间、峰值高度联合血流量评估老年重症急性胰腺炎患者并发胰周感染的特异度、曲线下面积(AUC)均高于单独评估。结论采用胰腺MSCT灌注扫描参数(达峰时间、峰值高度、血流量)联合诊断对鉴别老年重症急性胰腺炎是否并发胰周感染具有一定应用价值。

Objective To analyze the value of multislice spiral computed tomography(MSCT)perfusion scanning in identifying peripancreatic infection in elderly patients with severe acute pancreatitis.Methods MSCT perfusion scanning was performed on 110 patients with severe acute pancreatitis in our hospital,and the imaging characteristics and disease outcomes of the patients were analyzed.The MSCT perfusion scan parameters were compared between patients complicated with and without peripancreatic infection,and the receiver operating characteristic(ROC)curve was drawn to evaluate the value of MSCT perfusion scan parameters for peripancreatic infection.Results Among the enrolled patients,23 patients were complicated with peripancreatic infection,with the incidence rate of 20.91%and the case fatality rate of 0.91%.There was no statistically significant difference in the gender and age between patients complicated with and without peripancreatic infection(P>0.05),and the APACHEⅡscore of the patients complicated with peripancreatic infection was higher than that of patients complicated without peripancreatic infection(P<0.05).Patients complicated with peripancreatic infection had longer peak time,lower peak height,and less blood flow than patients complicated without peripancreatic infection,with statistically significant differences(P<0.05).ROC curve analysis showed that the specificity and area under the curve(AUC)of peak time and peak height combined with blood flow in the evaluation of peripancreatic infection in elderly patients with severe acute pancreatitis were higher than those of the single evaluation.Conclusion The combined diagnosis of pancreatic MSCT perfusion scan parameters(including peak time,peak height and blood flow)is of value in identifying whether severe acute pancreatitis complicated with peripancreatic infection in the elderly or not.