急性胰腺炎肾周间隙受累CT表现及在临床严重程度分型中的价值

目的：探讨急性胰腺炎（acute panereatitis，AP）累及肾周间隙（perirenal space，PS）的CT表现及其在临床严重程度分型中的价值。方法：收集2000年12月。2008年8月经CT检查并临床或手术证实的AP528例，分析PS受累89例CT表现，并分析其与临床严重程度分型对照关系。结果：重症AP受累率49．1％（81／165）明显高于轻症2．2％（8／363）（P〈0．01），PS受累CT表现为桥隔增粗模糊（85例），肾周脂肪间隙磨玻璃样改变（49例），积液（37例），不规则软组织密度影（9例），积液和不规则软组织密度影仅出现于重症AP。若以PS受累作为重症AP筛选标准，则敏感性49．1％（81／165），特异性97．8％（355／363），准确性82．6％（436／528）。结论：CT能准确显示AP肾周间隙受累情况，PS积液和软组织密度影为重症AP特征性表现，PS受累CT表现在临床AP严重程度分型中有一定的价值。

CT features of perirenal space involvement and its diagnostic value in clinical severity classification of acute pancreatitis

Objective：To evaluate the CT features of perirenal space（PS） involvement and its diagnostic value in clinical severity classification of acute panereatitis（AP）. Methods：528 cases of AP were retrospectively analyzed. The PS involvement appeared by CT in 89 eases. The CT features of PS involvement and its diagnostic value in clinical severity classification of tile 89 eases were evaluated. Results：The PS involvement was more common appeared in severe AP（49.1%, 81/165） in comparison with mild AP （2.2%, 8/363）（ P 〈 0.01）. CT features of PS involvement included： thickening and haziness of bridging septa （85 cases）, ground-glass opacity（49 eases）, effusion（37 cases）, irregular solid scrap（9 cases）. Effusion and irregular solid scrap appeared only in severe AP. If the PS involvement was considered as standard for screening the severe AP, the sensitivity was 49.1% （81/165）, specificity was 97.8% （355/363） and accuracy 82.6 % （436/528）. Conclusion： CT is an effective way to reveal the PS involvement, effusion and irregular solid scrap were the characteristic features of severe AP. CT features of PS involvement was useful in clinical severity classification of AP.