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重症胰腺炎的CT与MRI特点及诊治价值分析

作者:程 军

所属单位:湖北省潜江市中心医院普外一科(湖北 潜江 433100)

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摘要

目的 分析重症胰腺炎的CT及MRI 表现及其诊治价值。方法 收集我院收治 的40例重症胰腺炎患者的临床资料,患 者均已接受CT及MRI检查,总结其影像学 特点,比较CT及MRI在重症胰腺炎诊断中 的应用价值。结果 CT确诊重症胰腺炎37 例,误诊1例,与临床诊断符合36例,诊 断准确性为90.00%,敏感度为97.30%; MRI确诊36例,误诊1例,与临床诊断符 合35例,诊断准确性为87.50%,敏感度 为97.22%。MRI诊断重症胰腺炎准确性、 敏感度与CT检查对比差异无统计学意义 (P>0.05)。结论 CT可显示重症胰腺炎患 者胰腺形态结构,明确病变大小、范围及 其与附近脏器官关系,确定胰腺坏死程度 及渗液范围,且重复性好,价格低廉,可 作为重症胰腺炎早期筛查的首选方案。

Objective To analyze the CT and MRI manifestations and their value in diagnosis and treatment of severe acute pancreatitis. Methods The clinical data of 40 patients with severe acute pancreatitis were collected. All patients underwent CT and MRI examination. The imaging features were summarized. The application value of CT and MRI in the diagnosis of severe acute pancreatitis was compared. Results 37 cases of severe acute pancreatitis were diagnosed by CT and a case was misdiagnosed. 36 cases were in accordance with clinical diagnosis and the diagnostic accuracy was 90.00% and sensitivity was 97.30%; 36 cases were diagnosed by MRI and 1 case was misdiagnosed. 35 cases were in accordance with clinical diagnosis. The diagnostic accuracy was 87.50% and sensitivity was 97.22%. The differences in accuracy and sensitivity in diagnosis of severe acute pancreatitis between MRI and CT were not statistically significant (P>0.05). Conclusion CT can clearly show the morphology and structure of pancreas of patients with severe acute pancreatitis, determinate the relationship between the size and range of the lesions and nearby organs and determinate the severity of pancreatic necrosis and the extent of oozing. The repeatability is good and costs is low. It can be used as the first choice for early screening of severe acute pancreatitis.

【关键词】胰腺炎;MRI;CT;诊断

【中图分类号】R445.3;R445.2

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.04.030

前言

胰腺炎是临床常见急腹症,常见于成年人群,女性稍多于男性, 多由肝系病变或饮酒造成,严重者可能危及生命安全。重症胰腺炎为 胰腺炎特殊类型,患者多起病急,常伴恶心、呕吐、腹胀、发热等胃 肠道症状,上腹部呈持续性剧烈疼痛,可放射至胸背部,病情凶险, 病死率较高。因肝脏靠近胰腺,与静脉、胰腺、胆管交通,重症胰腺 炎患者多合并肝脏异常,伴不同程度的肝损伤,且致病机制复杂[1]。 基于此,为分析重症胰腺炎的CT、MRI影像学特点,明确其诊断价值, 我院对近年来收治的40例患者展开了研究,现报道如下。