不同年龄阶段急性胰腺炎局部并发症的MRI特征

The MRI Characteristics of Local Complications of Patients with Acute Pancreatitis Based on Ages

目的探讨不同年龄阶段急性胰腺炎(AP)局部并发症的MRI特征。方法 591例AP患者纳入研究,患者发病及入院5～7天行3. 0 T MRI检查。根据年龄将研究对象分3组:青年组(18～39岁),中年组(40～64岁),老年组(≥65岁)。分别记录AP患者临床指标和局部并发症MRI表现,比较3个年龄组的差异。结果胆源性和特发性AP常见于老年组(75%,18. 24%),其次中年组(55. 21%,16. 87%),再次青年组(29. 06%,8. 54%)。肝功能异常在青年组(52. 14%)低于中年组和老年组(76. 07%,77. 03%)。在MRI上,胃肠道改变在老年组最少(12. 16%),青年组和中年组(33. 33%,46. 01%)较多,差异具有统计学意义;肾周间隙受累与不同年龄阶段之间呈弱相关性(P <0. 05,r=0. 25)。对于坏死型AP,老年组更易并发弥漫性独立胰周坏死(66. 67%),而青年组和中年组更易并发胰腺坏死(61. 11%,71. 15%),差异具有统计学意义。结论不同年龄阶段AP局部并发症在临床和MRI上有不同的发病趋势。及时采取措施预防不同年龄患者高发的并发症,有助于更好地控制AP病程的进展。

Objective To study the MRI characteristics of local complications of patients with acute pancreatitis( AP)based on different ages. Methods There are 591 patients with AP included in the study. All of them received an abdominal MR scanning on 3. 0T MR scanner within 5-7 days after onset and admission. The patients were divided into three groups based on ages: Group young( 18 to 39 yrs),Group middle-aged( 40-64 yrs) and Group old( ≧ 65 yrs). The clinical records and MRI findings of local complications were assessed and compared among three groups. The clinical records include etiology,sex and liver function. The local complications include the necrosis of pancreas and peripancreatic fat,APassociated gastrointestinal abnormality and perirenal space involvement. Results Biliary and idiopathic AP were the most commonly found in the old age Group( 75%,18. 24%),then were middle age Group( 55. 21%,16. 87%),the last were young Group( 29. 06%,8. 54%). The prevalence of AP-associated liver-function abnormality in the young group( 52. 14%) was lower than those in other groups( 76. 07%,77. 03%). On MRI,the prevalence of AP-associated gastrointestinal abnormality in young and middle-age group( 33. 33%,46. 01%) was more common than those in the old Group( 12. 16%). The prevalence of perirenal space involvement was correlated with the different age stages( P < 0. 05,r =0. 25). For necrotizing AP,old Group was subject to extensive peripancreatic necrosis( 66. 67%) but young and middleaged Groups were subject to pancreatic necrosis( 61. 11%,71. 15%). Conclusion The local complications of AP patients in different age groups have different trends of risk on clinical findings and MRI. Timely measures to prevent high incidence of local complications in AP patients with different age are helpful for controlling the development of AP course.