急性胰腺炎的多层螺旋CT诊断

目的：探讨多层螺旋CT（MSCT）在急性胰腺炎（AP）诊断中的价值。方法：回顾性分析78例经手术病理及临床证实的AP患者的螺旋CT资料,全部病例均行CT平扫和增强扫描。结果：水肿性胰腺炎49例,出血坏死性29例。其中5例患者合并脓肿,4例死亡。按Balthazar分级：A级5例,B级19例,C级21例,D级18例,E级15例。左膈下脂肪浸润（LSFI）占急性出血坏死性胰腺炎的41.38%（12/29）。肾周间隙（PS）受累占急性出血坏死性胰腺炎的48.28%（14/29）,肾旁后间隙（PPS）受累占急性出血坏死性胰腺炎的44.83%（13/29）。结论：螺旋CT对AP具有定性诊断价值,Balthazar分级、胰腺坏死分型、LSFI、PS及PPS受累对急性出血坏死性胰腺炎的病情判断有很大价值。

MSCT diagnosis of acute pancreatitis

Objective: To evaluate the multislice spiral CT(MSCT) in diagnosis of acute pancreatitis.Methods: Seventy-eight cases of acute pancreatitis confirmed by operation,pathology and clinical diagnosis were analyed respectively.All patients underwent CT pre and post-contrast scannings.Results: According to clinical diagnosis,they were devided into edematous type(n=49) and necrotic type(n=29),5 cases were complicated with abscesses,and 4 casess died.According to CT features,grade A,n=5;grade B,n=19;grade C,n=21;grade D,n=18;grade E,n=15.Among the 29 cases necrotizing pancreatitis,the incidence of the left subphrenic fat infiltration(LSFI) was about 41.38%.,the incidence of the Perinephric Space(PS) involvement was 48.28%,the incidence of the posterior pararenal space(PPS) involvement was 44.83 %.Conclusion: CT is valuable for the diagnosis of AP;grading of the CT findings,necrotic type,LSFI,PS and PPS involvement were helpful to judge progression and prognosis with necrotizing pancreatitis.