儿童急性胰腺炎的CT表现

目的：探讨儿童急性胰腺炎的CT特征及其CT检查价值。材料和方法：回顾性分析58例临床确诊的急性胰腺炎病例的临床和CT资料。结果：单纯水肿型胰腺炎43例（占74．1％），出血坏死型胰腺炎15例（占25．9％）。儿童胰腺炎CT表现包括：①胰腺本身改变：胰腺局部或弥漫性增大46例（占79．3％），密度改变18例（占31％），胰腺断裂2例（占3．4％），胰腺包膜掀起6例（占10．3％）。②胰外改变：主要为胰外积液，共38例占（65．5％）。胰外积液中以肾旁前间隙积液最多，有30例（占51．7％），小网膜囊积液次之，为26例（占44．8％）。③并发症：包括假性囊肿14例（占24．1％）、脓肿1例（占1．7％）等。结论：儿童胰腺炎胰腺坏死的发生率低，并发假性囊肿、脓肿较少，但胰外积液的发生率高。CT对儿童胰腺炎的诊断、病情监测、治疗评估等都有很大意义。

CT Features of Acute Pancreatitis in Children

Purpose:To explore the CT features and the value of CT examination for diagnosising acute pancreatitis in children. Materials and Methods:The clinical and CT examination data of 58 cases, who were finally diagnosed acute pancreatitis in children, were retrospectively analyzed.Results:Among the 58 patients, 43 cases (74.1%) were diagnosed as mild acute pancreatitis(acute edematous pancreatitis),and the other 15 cases(25.9%) were severe pancreatitis(acute hemorrhagic and necrotized pancreatitis). The CT features of pancreatitis in this group included pancreatic abnormalities, extrapancreatic abnormalities and complications. The pancreatic abnormalities included as follows: partial or entire enlargement of the pancreas(46 cases,79.3%), focal areas of decreased attenuation(18 cases,31%), pancreatic fracture(2cases,3.4%) and peripancreatic capsule lifting(6 cases,10.3%). Thirty-eight cases (65.5%) were associated with extrapancreatic fluid collections. Extrapancreatic fluid collection was most commonly seen in the anterior pararenal space(30 cases,51.7%), followed by the lesser sac(26 cases, 44.8%). The complications included pseudocysts(14cases, 24.1%), abscess(1case,1.7%), and so on.Conclusion:The incidences of necrosis, pseudocyst and abscess associated with pancreatitis is low in children, while the extrapancreatic fluid collection is frequently detected. CT examination is of great value in diagnosing, monitoring and assessing the pancretitis in children.