AP腹膜下间隙扩散MRI影像学表现与APACHEⅡ评分的相关性分析

Correlation Analysis of MRI Imaging Findings and APACHEⅡScore of Subperitoneal Space Siffusion in Scute Pancreatitis

目的分析急性胰腺炎(AP)腹膜下间隙扩散MRI影像学表现与急性生理与慢性健康评分(APACHEⅡ)评分的相关性。方法收集本院2019年2月-2021年2月收治的114例AP患者的临床资料,整理术前MRI检查图像,参考CT扩散范围分级将腹膜下间隙受分3级,记录患者腹膜下间隙受累情况,对比不同MR严重指数(MRSI)评分分型、APACHEⅡ评分分型患者的膜下间隙受累评分,分析腹膜下间隙受累评分与MRSI评分、APACHEⅡ评分相关性。结果114例患者中78例(68.42%)存在度腹膜下间隙受累情况:1级13例,2级18例,3级47例,腹膜下间隙受累评分为(2.15±0.73)分。合并网膜、韧带及网膜囊受累者MRI可见其网膜韧带增厚、分层并伴有有积液,患者网膜囊可见积液,T1WI为等或低信号,T2WI非脂肪抑制序列表现为高信号;合并肠系膜、肠管受累者MRI上可见肠系膜水肿、增厚,且伴有肠管管壁增厚。结肠旁沟受累者T1WI为低信号,T2WI非脂肪抑制序列为高信号。MRSI评分、APACHEⅡ评分分型下,腹膜下间隙受累评分比较均存在差异,随分型严重程度增加,腹膜下间隙受累评分随之上升(P<0.05)。进一步经Pearson相关性分析显示:腹膜下间隙受累评分与MRSI评分、APACHEⅡ评分之间均存在正相关关系(P<0.05)。结论腹膜下间隙受累与APACHEⅡ评分存在一定联系,通过MRI检查可有效评估AP患者腹膜下间隙扩散情况,可作为评估患者病情严重程度的有效方法。

Objective To analyze the correlation between MRI imaging findings and acute physiology and chronic health score(APACHEⅡ)of subperitoneal space diffusion in acute pancreatitis(AP).Methods The clinical data of 114 patients with AP admitted to our hospital from February 2019 to February 2021 were collected,the preoperative MRI images were sorted out,and the subperitoneal space involvement was divided into 3 levels with reference to the CT diffusion range classification,and the involvement of the subperitoneal space was recorded,the subperitoneal space involvement scores of patients with different MR severity index(MRSI)and APACHEⅡscore types were compared,and the correlation between the subperitoneal space involvement score and MRSI score and APACHEⅡscore was analyzed.Results 78 cases of the 114 patients(68.42%)had subperitoneal space involvement:13 cases of grade 1,18 cases of grade 2,47 cases of grade 3,and the score of subperitoneal space involvement was(2.15±0.73).In patients with omentum,ligament,and omental sac involvement,MRI showed that the omental ligament was thickened,layered,and accompanied by effusion,and fluid can be seen in the omentum sac of patients,T1WI was iso-or hypointensity,and T2WI non-fat-suppressed sequence was hyperintensity;The patients with mesentery and bowel involvement,mesentery edema and thickening could be seen on MRI,accompanied by thickening of the intestinal tube wall.The patients with paracolic groove involvement showed low signal on T1WI and high signal on non-fat suppressed sequences on T2WI.There were differences in the subperitoneal space involvement scores under the MRSI score and APACHEⅡscore classification,and with the severity of the classification the subperitoneal space involvement score increased(P<0.05).Further Pearson correlation analysis showed that there was a positive correlation between the subperitoneal space involvement score,MRSI score and APACHEⅡscore(P<0.05).Conclusion There is a certain relationship between the involvement of the subperitoneal space and the APACHEⅡscore,the MRI examination can effectively evaluate the spread of the subperitoneal space in patients with AP,which can be used as an effective method to evaluate the severity of the patient's condition.