急性胰腺炎胰腺微循环损害的MSCT灌注成像

目的：探讨急性胰腺炎胰腺微循环损害的特点及MSCT灌注成像的临床应用价值。方法：采用急性胰腺炎的临床分级和Balthazar CT分级标准,将入院后48h内的69例急性胰腺炎患者分为轻症组（MAP）42例（CT分级为A级16例,B级9例,C级17例）和重症组（SAP）27例（CT分级为D级11例,E级16例）,以12例无胰腺疾病的胸部CT检查患者作为对照组。所有患者均行MSCT胰腺灌注扫描,测量参数包括胰腺的时间-密度曲线（TDC）以及灌注参数：血流量（BF）、血容量（BV）、平均通过时间（MTT）和表面通透性（PS）。结果：急性胰腺炎时胰腺TDC上升斜率较小,峰值降低。正常胰腺、MAP和SAP三组中胰腺的BV值依次下降,且相互间差异均有显著性意义（P〈0.05）;SAP组胰腺BF、BV值均低于MAP组,MTT、PS均增高,差异有显著性意义（P〈0.05）。MAP组中CT分级为A级者较正常胰腺组BF值增高,B、C级较正常胰腺组BF、BV减低,PS增高（P〈0.05）。结论：急性胰腺炎患者的胰腺血流灌注状态与其严重程度关系密切,它呈先升后降的趋势。MSCT灌注成像可以定量评价胰腺的微循环状况,对急性胰腺炎的早期分级有潜在应用价值。

MSCT Perfusion Imaging of Pancreatic Microcirculatory Impairment in Acute Pancreatitis

Objective:To investigate the characteristics of microcirculatory impairment in acute pancreatitis and the value of MSCT perfusion imaging in clinical application.Methods:According to the clinical diagnostic criteria and Balthazar plain CT scan score,69 acute pancreatitis patients within 48 hours of hospitalization including 42 cases of mild acute pancreatitis (MAP,CT grade A=16,B=9,C=17) and 27 cases of severe acute pancreatitis (SAP,CT grade D=11,E=16) as well as 12 control patients taking chest CT but wit...