急性胰腺炎患者小网膜腹膜下间隙受累情况与Balthazar CT分级的相关性研究

Involvement of Subperitoneal Space in Small Omentum and its Correlation with Balthazar CT Classification of Patients with Acute Pancreatitis

目的研究急性胰腺炎(AP)患者小网膜腹膜下间隙受累情况与Balthazar CT分级的相关性。方法回顾性分析2018年6月至2020年5月收治且经手术病理或生化指标检测确诊的64例AP患者的临床资料。观察肝十二指肠韧带及肝胃韧带的受累及Balthazar CT分级情况。结果64例AP患者Balthazar CT分级:C级6例;D级20例;E级38例。肝十二指肠韧带受累者共48例;肝胃韧带受累者共54例。Balthazar CT分级C级患者,肝十二指肠韧带、肝胃韧带受累的阳性率显著低于D级、E级(P<0.05);Balthazar CT分级越高,肝十二指肠韧带及肝胃韧带受累越严重,呈显著正相关(P<0.01)。CT扫描图像可见病变呈弥漫性增大,增大程度与严重程度成正比,胰周脂肪间隙模糊、间隙消失,胰腺因炎性渗出而模糊不清。结论MSCT检查可有效显示AP患者小网膜腹膜下间隙受累情况,且在一定程度上反应AP严重程度。

Objective To study the involvement of subperitoneal space in small omentum and its correlation with Balthazar CT classification of patients with acute pancreatitis(AP).Methods The clinical data of 64 AP patients admitted between June 2018 and May 2020 and diagnosed by surgical pathology or biochemical indicators were analyzed retrospectively.The involvement of the hepatoduodenal ligament and the hepatogastric ligament and the Balthazar CT grading were observed.Results Balthazar CT classification of 64 patients with AP:6 cases were in grade C;20 cases were in grade D;38 cases were in grade E.There were 48 cases with involvement of hepatoduodenal ligament,54 cases with involvement of hepatogastric ligament.In patients at grade C of Balthazar CT,the positive rate of involvement of hepatic duodenal ligament and hepatogastric ligament was significantly lower than that of patients at grade D and E(P<0.05).The higher the Balthazar CT grading was,the more severe the involvement of hepatic duodenal ligament and hepatogastric ligament was,which showed a significant positive correlation(P<0.01).The CT scan image showed that the lesion shows diffuse increasing,and the degree of increasing was positively correlated with the severity.Fat gaps around the pancreas were blurred and the gap disappeared,and the pancreas was blurred due to inflammatory exudation.Conclusion MSCT examination can effectively show the involvement of subperitoneal space in small omentum of AP patients,and to some extent,it reflects the severity of AP.