CT对急性胰腺炎胸部损伤的评估价值

Evaluation of CT to chest injury in acute pancreatitis

目的:探讨急性胰腺炎(AP)胸部损伤的CT表现及判断标准。方法:回顾性分析111例AP患者,根据病情严重程度,分为轻度组29例、中度组64例和重度组18例;根据肺部损伤及胸膜腔受累情况,分为未受累、轻度损伤、中度损伤和重度损伤。分析胸部损伤的发生率、CT表现,以及胸部损伤发生率、CT分级与AP严重程度的相关性。结果:轻度组、中度组、重度组胸部损伤发生率依次为48.3%(14/29)、93.8%(60/64)、100.0%(18/18),胰腺炎越严重,胸部损伤的发生率越高(χ2=33.526,P<0.001)。轻度组轻度、中度、重度胸部损伤发生率依次为24.1%(7/29)、24.1%(7/29)、0(0/29),中度组依次为9.4%(6/64)、59.4%(38/64)、25.0%(16/64),重度组依次为22.2%(4/18)、33.3%(6/18)、44.5%(8/18);与轻度AP相比,重度AP的胸部损伤CT分级更高(H=36.876,P<0.01)。结论:AP引起胸部损伤的发生率及CT分级均与AP严重程度具有相关性,可作为判断AP病情严重程度的影像学重要参考依据。

Objective:To explore the CT manifestations and diagnostic criteria of chest injury in acute pancreatitis(AP).Methods:Retrospective analysis was performed on 111 patients with AP,and 111 patients were categorized into the mild AP group(29 cases),the moderate AP group(64 cases)and the severe AP group(18 cases)depending on the disease severity.According to CT features of lung injury and pleural involvement,the chest injury in AP patients was divided into 4 grades,non-involvement,mild-involvement,moderate-involvement and severe-involvement.The incidence and CT features grade of chest injuries and their correlation with the disease severity were analyzed.Results:The incidence of chest injuries in the mild,moderate and severe AP group was 48.3%(14/29),93.8%(60/64)and 100%(18/18),respectively,showed that the more severe the pancreatitis,the higher the incidence of chest injuries(χ2=33.526,P<0.001).The incidences of mild-,moderate-and severe-involvement in the mild AP group were 24.1%(7/29),24.1%(7/29)and 0(0/29),and those in the moderate AP group were 9.4%(6/64),59.4%(38/64)and 25.0%(16/64),and those in the severe AP group were 22.2%(4/18),33.3%(6/18)and 44.5%(8/18),respectively.Compared with the mild AP group,the CT features grade in the severe AP group was higher(H=36.876,P<0.01).Conclusions:The incidence of chest injury caused by AP and its CT features grade are correlated with the severity of AP,which can serve as an important imaging reference for judging the severity of AP.