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CT、MRI对急性胰腺炎的诊断价值比较

作者:陈 宏

所属单位:陕西省汉中市中心医院(陕西 汉中 723000)

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摘要

目的 比较CT或MRI对急性胰腺 炎的诊断价值。方法 以我院2013年1 月-2015年6月就诊的60例疑似急性胰腺 炎患者为研究对象,所有患者均行CT、 MRI检查,观察CT、MRI影像学表现,并 与病理结果对照比较CT、MRI对急性胰 腺炎诊断敏感度、特异度及准确度。结 果 CT表现:急性水肿型胰腺炎表现出胰 腺肿大、形态规则、胰腺密度较均匀、 胰管、胆管轻中度扩张特点;急性坏死 型胰腺炎2表现出胰腺密度不均匀、体积 明显增大、斑片状或大片状低密度灶特 点。MRI表现:多为胰腺明显肿大、胰腺 病变区、胰腺周边组织呈现长T1、长T2 信号影特点。病理确诊48例,CT诊断敏 感度、准确度分别为77.1%、76.7%,显 著低于MRI的93.8%、93.3%(P<0.05)。 结论 CT、MRI表现对急性胰腺炎诊断均有 一定的诊断价值,其中MRI诊断敏感度、 准确率、特异度均比CT高。

Objective To compare the value of CT and MRI in the diagnosis of acute pancreatitis. Methods 60 patients with suspected acute pancreatitis treated in our hospital from January 2013 to June 2015 were treated as the research objects. All patients underwent CT and MRI examination. The imaging findings of CT and MRI were observed and compared with pathological findings. The sensitivity, specificity and accuracy of CT and MRI in the diagnosis of acute pancreatitis were compared. Results CT findings: acute edema type pancreatitis showed pancreatic enlargement, regular shape, relatively homogeneous pancreatic density and mild to moderate expansion of pancreatic duct and bile duct; Acute necrotizing pancreatitis showed inhomogeneous pancreatic density, significantly increased volume and patchy or large-sheet low-density lesions. MRI findings: most were obvious enlargement of the pancreas, long T1, long T2 signal in the pancreatic lesion area and the peripheral tissue of the pancreas. 48 cases were diagnosed by pathology. The sensitivity and accuracy of CT were 77.1% and 76.7% respectively which were significantly lower than those of MRI (93.8%, 93.3%) (P<0.05). Conclusion CT and MRI expression in the diagnosis of acute pancreatitis have certain diagnostic value and the diagnostic sensitivity, accuracy and specificity of MRI were higher than those of CT.

【关键词】急性胰腺炎;CT;MRI;影像 学表现;诊断价值

【中图分类号】R576

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.05.031

前言

急性胰腺炎作为临床一种常见急腹症,典型特征是胰腺及周边组 织出现水肿、炎性渗出等急性化学性炎症,发病突然且进展快,易引 发感染、休克等系列并发症,预后差[1-2]。目前临床诊断急性胰腺炎包 括临床表现、实验室检查、影像学检查等,其中影像学检查重要手段 为CT、MRI,CT具有快速扫描、后处理技术强大特点,MRI具有软组织 分辨力高、成像技术等特点,对急性胰腺炎诊断准确率较高,被认为 是急性胰腺炎分型、疾病严重程度、治疗方案制定及效果评估的重要 方法。基于此,本研究通过与病理结果比较,分析CT、MRI对急性胰腺 炎的诊断价值,报告如下。