目的 探讨超声内镜、腹部CT对 不同分期胰腺炎的临床鉴别诊断价值。 方法 选取我院2012年6月至2016年6月4 年间收治的72例慢性胰腺炎患者为研究 对象，均行超声内镜、腹部CT检查并分 析影像学表现，与临床分期诊断结果相 比较，比较两种检查方法的临床分期阳 性诊断率。结果 超声内镜对胰腺炎的1 期诊断阳性率81.48%明显高于腹部CT诊 断阳性率55.56%(P＜0.05)，两组2期、 3期诊断阳性率比较无统计学意义(P＞ 0.05)。超声内镜影像学表现：1期、2 期胰腺组织增强时相与周围组织同步， 腺组织血管呈均匀等增强；3期胰腺组织 血管呈稀疏不均匀低增强；腹部CT影像 学表现：1期胰腺边界较为清晰，密度相 对均匀；2期胰腺边界相对模糊，密度不 均，可见不同程度的胰腺肿大及条状或 斑片状高密度影；3期胰周脂肪层消失， 轮廓模糊，可见低密度坏死灶及胰周不 同程度积液、高密度积血；1-3期强化程 度不同。结论 超声内镜、腹部CT对不同 分期胰腺炎的临床鉴别均具有较高的阳 性诊断率和不同分期的影像学表现，临 床可根据实际选择进行鉴别诊断。

Objective To evaluate the value of endoscopic ultrasonography and abdominal CT in the differential diagnosis of pancreatitis in different stages. Methods Seventy-two patients with chronic pancreatitis treated in our hospital between June 2012 and June 2016 were selected as study subjects. All underwent endoscopic ultrasonography and abdominal CT, and the imaging findings were analyzed and compared with the results of clinical staging. The diagnostic positive rate of clinical stage were compared between the two methods. Results The positive rate of endoscopic ultrasonography in the diagnosis of pancreatitis in stage 1 was 81.48%, significantly higher than that of abdominal CT (55.56%) (P＜0.05). There were no significant differences in the diagnostic positive rate of stage 2 and stage 3 between the two methods (P＞0.05). Imaging findings of endoscopic ultrasonography: the enhanced images of pancreatic tissues in stage 1 and 2 were the same with surrounding tissues, blood vessels in glandular tissues showed homogeneous enhancement; blood vessels in glandular tissues in stage 3 showed sparse, inhomogeneous and low enhancement; Imaging findings of abdominal: the boundaries of pancreas in stage 1 was relatively clear, the density was relatively homogeneous; in stage 2, the boundaries were relatively blur and the density was inhomogeneous, there were different degrees of enlargement of pancreas and strip or patchy high density shadow; in stage 3, the fat layer surrounding pancreas disappeared, the outline was fuzzy, and there were low-density necrosis and different degrees of hydrops and high-density hematocele surrounding pancreas. In stage 1-3, there were different degrees of enhancement. Conclusion Both of endoscopic ultrasonography and abdominal CT is with high positive diagnostic rate and different imaging findings in the diagnosis of pancreatitis in different stages. The two methods can be chosen according to the actual situation.