目的 探讨CT对急性胰腺炎严重 程度诊断价值。方法 2014年2月-2015年 1月我院收治的急性胰腺炎患者73例，所 有急性胰腺炎的患者均用普通CT和增强CT 扫描，总结影像学资料并进行回顾性分 析。结果 水肿性胰腺炎64例，出血坏死 性胰腺炎9例。急性水肿性胰腺炎病例CT 扫描中，9例胰腺未见明显异常；14例胰 腺弥散性肿胀；7例局灶性肿胀；26例胰 周间隙密度增高、模糊；8例出现单发性 积液。急性出血性坏死性胰腺炎病例CT扫 描中，9例小网膜囊均有积液；4例弥漫性 出血；5例灶性出血；6例出现胰周积液， 1例出现右肾后间隙积液，2例出现左肾旁 间隙积液，在急性出血性坏死性胰腺炎 中，全胰腺坏死2例，胰头部坏死2例，段 状坏死2例，尾部坏死3例。增强CT动态扫 描显示胰腺坏死区域与正常胰腺组织有明 显的差异。结论 CT在急性胰腺炎严重程 度诊断中具有重要的价值。特别是对急性 出血坏死性胰腺炎的诊断，增强CT具有简 便性，可靠性，高敏感性等优点。

Objective To study the diagnosis value of CT in the severity of acute pancreatitis. Methods In February 2014 to January 2015，there were 73 patients with acute pancreatitis treated in our hospital and all the patients underwent CT plain and contrast-enhanced scanning. We conducted retrospective analysis with these CT imaging data. Results Among all the 73 case, edematous pancreatitis were 64 cases, hemorrhagic necrotic pancreatitis were 9 cases. In the acute edematous pancreatitis cases CT scans, 9 cases did not see obvious exception; 14 cases of pancreas diffuse swelling; 7 cases of focal swelling; 26 cases of density and fuzzy with peripancreatic gap; 8 cases of the single effusion. In acute hemorrhagic necrotizing pancreatitis cases CT scans, 9 cases were lesser sac effusion; 4 cases of diffuse hemorrhage; 5 cases of focal hemorrhage; peripancreatic effusion in 6 cases; one case of kidney after a gap appears effusion; 2 cases effusion appears next to the left renal clearance. In necrotizing pancreatitis, pancreatic necrosis whole two cases, two cases of pancreatic head necrosis, two cases of necrosis segment, three cases of pancreatic tail necrosis. With dynamic enhanced CT scanning, the necrosis area was more significantly when compared with normal pancreatic tissue. Conclusion CT is of important diagnosis value in acute pancreatitis severity, especially for the diagnosis of acute hemorrhagic necrotizing pancreatitis, the enhancement CT with the advantages of simplicity, reliability, high sensitivity, etc.