急性胰腺炎肝脏损害的CT表现

目的 描述急性胰腺炎暂时性肝脏密度减低的CT表现,探讨其发生机理.方法 回顾123例急性胰腺炎患者的肝脏CT表现,25例胰腺炎治疗后复查CT,29例进行上腹部三期增强扫描,采用16层螺旋CT机,重建层厚为5mm.结果 123例患者中,53例CT显示肝脏密度普遍减低(脂肪肝)占43%(53/123);53例脂肪肝中,25例在15天-4个月复查CT,所有脂肪肝都有所减轻,其中5例完全恢复正常肝实质密度.29例患者增强扫描显示典型急性胰腺炎增强表现,其中23例肝脏强化较均匀,6例肝脏出现一过性灌注异常,其中4例肝实质呈散在、斑片状明显强化区,左叶楔形强化1例,胆囊窝周围肝实质强化1例.结论 CT可以很好地显示急性胰腺炎对肝脏造成的损害,对临床治疗具有重要指导意义.

CT appearance of liver injury in acute pancreatitis

Objective To describe the CT appearances of hepatic injury in patients with acute pancreatitis and discuss its mechanism. Methods We reviewed CT scan of 123 patients with acute pancreatitis. In 123 patients,25 patients were followed by CT scan from fifteen days to four months after treatment,In 29 patients,three-phase dynamic CT studies of upper abdomen were performed. Results In 123 patients with acute pancreatitis, hepatic density of 53 patients decreased.In 5 of 25 following patients,hepatic density became normal. In 6 of 29 patients transient hepatic attenuation differences were found. Conclusion CT is a better technique for showing hepatic injury (fatty liver and transient hepatic attenuation differences) and assessing the prognosis of patients with acute pancreatitis.