螺旋CT在急性胰腺炎诊断中的应用价值

目的 探讨螺旋CT在急性胰腺炎诊断中的价值。方法 收集1997-2002年间经临床和螺旋CT确诊的急性胰腺炎45例，其中男27例，女18例。所有病例均作平扫和增强白扫描。将胰腺坏死分为3型：Ⅰ型即为即点片状坏死，Ⅱ型为段状坏死（坏死部分超过整个胰腺的30%，坏死范围贯穿胰腺全层），Ⅲ型为全胰腺坏死（超过胰腺50%的段状坏死）。结果 水肿性胰腺炎26例，出血坏死性19例。按Balthazar分级：A级5例，B级9例，C级12例，D级11例，E级8例。近胰腺坏死分型Ⅰ型5例，Ⅱg型5例，Ⅲ型6例。结论 螺旋CT检查对急性胰腺炎具有定性诊断价值。CT分级与胰腺坏死分型对急性出血坏死性胰腺炎病情的判断具有很大价值。

Evaluation of Spiral CT in Diagnosis of Acute Pancreatitis

Objective To evaluate the diagnosis of acute pancreatitis withspiral CT. Methods 45 patients,27 male and 18 female,with clinicallyconfirmed acute pancreatitis were examined with routine and contrastenhanced spiral CT. Results Acute pancreatitis was classified into 3types according to the extent of tissue necrosis of the pancreas:In the firsttype,there were points or pieces of scattered necrosis in the pancreas,necrosis of the whole depth of pancreatic tissue involving 30 percent ofthe pancreas occurred in the second type and necrosis involving morethan 50 percent of the pancreas was found in third type.Clinically,edematous pancreatitis was found in 26 cases and necrotic pancreatitis in19 cases,According to the CT features,grade A pancreatitis occurred in5 cases,grade B in 9 cases,grade C in 12 cases,grade D in 11 cases andgrade E in 8 cases.Contrast-enhanced CT revealed that 5 cases weregrouped into the first type,5 cases into the second type and 6 cases intothe third type. Conclusion Spiral CT is valuable for the diagnosis ofacute pancreatitis. Necrotic pancreatitis results in poor prognosis of thepatients.Grading of the CT features if helpful to judge the prognosis ofpatients with acute pancreatitis.