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外伤性胰腺炎的CT 影像表现特点分析

作者:任玉清1 龚福林1 袁 冬1 徐 丽1 陈喜兰2

所属单位:1.武汉大学人民医院钟祥医院(湖 北省钟祥市人民医院)放射影像 科 (湖北 钟祥 431900) 2.武汉大学人民医院(湖北省人民 医院) (湖北 武汉 430064)

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摘要

目的 探讨外伤性胰腺炎的CT影 像表现特点。方法 选取我院于2012年2 月-2014年10月收治的81例外伤性胰腺 炎患者为研究对象,将其归入研究组(A 组,n=81);将同期入院就诊的81例普通 胰腺炎患者纳入对照组(B组,n=81)。两 组患者均接受CT检查,观察其CT图像, 记录其在CT征象、胰腺形态、肾筋膜形 态、胰腺结构、假性囊肿发生情况、积液 情况、腹腔内游离气体情况及周围脂肪 间隙密度变化情况等CT表现上的对比差 异。结果 两组患者在肾周或胸腔积水、 肾筋膜形态改变及假性囊肿发生率等CT 表现对比上均无统计学意义(P>0.05); A组患者中单个CT征象者56例(69.1%), 显著高于B组患者的27例(33.3%),差异 具有统计学意义(P<0.05);B组患者中小 网膜积液者29例(35.8%),腹腔积液者25 例(30.9%),胰腺形态增大且胰腺结构清 晰者33例(40.7%),周围脂肪间隙密度者 23例(28.4%),腹腔内游离气体者15例 (18.5%),均显著高于A组的9例(11.1%), 7例(8.6%),7例(8.6%),7例(8.6%)和5例 (6.2%),差异具有统计学意义(P<0.05)。 结论 CT影像学检查可作为临床鉴别外伤 性胰腺炎及普通胰腺炎的重要依据,值得 临床推广。

Objective Toexplore the CT imaging features of traumatic pancreatitis. Methods 81 cases of patientswith traumatic pancreatitis admitted intothe hospital from February 2012 to October 2014 wereslected as the research object which was included in the research group (group A, n=81), 81 cases of patients with common pancreatitis over the same period admitted into the hospital were included into the control group (group B, n=81). The two groups of patients all received CT examination. The CT images were observed. The differences in CT signs, pancreatic form, the form of renal fascia, the structure of the pancreas, the occurrence of pseudocyst, conditions of effusion andintraperitoneal free gas and the changes of surrounding fat space density were recorded. Results The differences in perirenal and pleural effusion, morphological changes of renal fascia and the occurrence of pseudocystin the two groups of patients were not statistically significant (P>0.05). There 56 cases (69.1%)of patients with single CT sign in group A which were significantly higher than 27 cases (33.3%)in group B and the difference was statistically significant (P<0.05), in group B, there were 29 cases(35.8%) of omental effusion, 25 cases(30.9%) of peritoneal effusion, 33 cases(40.7%) of enlargement of pancreatic form and distinct structure of the pancreas, 23 cases of (28.4%)surrounding fat space density, 15 cases (18.5%) of intraperitoneal free air, which were significantly higher than 9 cases (11.1%), 7 cases (8.6%), 7 cases (8.6%), 7 cases (8.6%) and 5 cases (6.2%) in group A and the differences were statistically significant (P<0.05). Conclusion CT imageological examination can be used as the important basis for clinical differential diagnosis of traumatic pancreatitis and common pancreatitis, which is worthy of clinical popularization.

【关键词】外伤性胰腺炎;CT检查;影像 表现

【中图分类号】R657.5+1

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.09.020

前言

临床研究表明,外伤性胰腺炎作为胰腺炎的少见分型,继胰腺损 伤后引起,其发病率为普通胰腺炎的1%~2%,早期诊断及治疗是促进 病情转归、降低死亡风险的关键[1]。相关研究表明,多数胰腺损伤患 者因早期症状具有较强隐匿性[2],在其腹部症状明显时才予以关注及 积极的诊疗措施,易耽误病情而增加致死风险,于其预后提升不利。 随着医疗技术的革新及临床经验的积累,越来越多学者试图利用影像 学检查对外伤性胰腺炎予以早期诊断,以缩短诊疗时间,增加早期治 疗有效性。本次研究以此为方向,选取外伤性胰腺炎及普通胰腺炎患 者各81例为研究对象并对其予以CT影像检查,以探讨外伤性胰腺炎的 CT影像表现特点,提高早期诊断准确性,现报告如下。