急性胰腺炎患者超声表现与CT表现对比分析

目的 比较急性胰腺炎(AP)患者超声与CT表现,评价超声和CT对AP的诊断价值.方法 回顾性分析98例临床和手术病理证实的AP患者超声表现和CT表现,并进行比较.其中轻型AP患者74例,重症AP患者24例.结果 参照Balthazar CT分级标准,本组98例AP患者超声表现为A级为23.5%(23/98),CT为22.4%(22/98),差异无统计学意义(χ2=0.0288,P=0.8651);B级为81.6%(80/98),CT为79.5%(78/98),差异无统计学意义(χ2=0.1306,P=0.7178);C级为35.7%(35/98),低于CT的55.1%(54/98),差异有统计学意义(χ2=7.4300,P=0.0064);D级为49.0%(48/98),高于CT的38.8%(38/98),差异有统计学意义(χ2=7.0719,P=0.0054);E级为10.2%(10/98),低于CT的24.5%(24/98),差异有统计学意义(χ2=8.9746,P=0.0083).本组74例轻型AP患者超声检查诊断正确65例(87.8%),误诊6例(8.1%),不能给出明确诊断3例(4.1%);CT诊断正确61例(82.3%),误诊7例(9.5%),不能给出明确诊断6例(8.1%).本组24例重症AP患者超声检查诊断正确8例(33.3%),误诊6例(25.0%),不能给出明确诊断4例(16.7%).CT诊断正确率为100%.结论 对于轻型AP患者,超声诊断准确率与CT相近,二者可互补;对于重症AP患者,CT诊断准确率高于超声.

Comparison of ultrasonography and CT in patients with acute pancreatitis

Objective To compare the characteristics of ultrasound and CT in patients with acute pancreatitis. Methods The ultrasound and CT images of 98 patients with acute pancreatitis were retrospectively analyzed . The diagnosis was confirmed by surgical pathology. Among the 98 patients ,74 were diagnosed as mild acute pancreatitis, 24 were diagnosed as severe acute pancreatitis. Results The positive diagnostic rate of the 98 patients with acute pancreatitis： ultrasound （level A）23.5% （23/98） , CT 22.4% （ 22/98 ）, the difference was statisticallyslgmficant （X^2 = 7. 4300, P = 0. 0064 ） ; Bahhazar CT （ level B ） 81.6% （ 80/98 ） , CT 79.5% （ 78/98 ）, difference was statistically significant （X2 = 0. 1306, P = 0. 7178 ） ; Balthazar CT （ level C ） 35.7% （ 35/98 ）, 55. 1% （ 54/98 ） lower than CT, the difference was statistically significant （X2 = 7. 4300, P = 0. 0064 ） ; Bahhazar CT （ level D） 49.0% （ 48/98 ）, 38.8 % （ 38/98 ） higher than C, the difference was statistically significant 0（2 = 7.0719, P = 0. 0054） ; Bahhazar CT （level E ） 10. 2% （ 10/98 ）, 24.5% （24/98） lower than CT, the difference was statistically significant （X2 = 8. 9746, P = 0. 0083 ）. Sixty-five （87.8%）of the 74 patients with mild acute pancreatitis were diagnosed accurately ,6 （8.1% ）cases were inaccurately diagnosed, 3 （4.1% ） cases with undetermined diagnosis ; CT ： accurate ,61 （82.3%）,inaccurate, 7（9.5% ）,6（8.1% ）with undetermined diagnosis. In the 24 patients with severe acute pancreatitis：8（33.3% ） cases were diagnosed by ultrasound accurately, 6 （ 25.0% ） cases were misdiagnosed, 4 （ 16. 7% ） cases with undetermined diagnosis. The diagnostic accuracy of CT was 100%. Conclusions For patients with mild acute pancreatitis ,the diagnostic accuracy of ultrasound is similar to CT. The two imaging modalities are complements to each other. For patients with severe acute pancreatitis,CT is more valuable for the diagnosis than ultrasound.