目的 探讨CT与MRI在反映急性 重症胰腺炎患者腹壁受累中临床价值。 方法 选取70例急性重症胰腺炎患者， 超声检查结果显示为高度可疑的腹壁受 累，均于发病7d内先后行CT、MRI检查， 影像学资料完整。比较CT与MRI腹壁受 累检出率，分析急性重症胰腺炎腹壁受 累CT与MRI表现。结果 CT扫描共发现腹 壁密度异常者37例，腹壁受累检出率为 52.86%。MRI扫描共发现腹壁信号异常者 40例，腹壁受累检出率为57.14%。70例 患者中，CT与MRI累计共发现腹壁受累46 例(65.71%)，CT与MRI检出率差异比较无 统计学意义(P＞0.05)。CT、MRI显示腹 壁异常部位包括单侧、双侧腹壁，以侧 腹壁异常居多。CT平扫显示腹壁脂肪层 密度增高，肌肉-脂肪间隙分界模糊；肌 肉组织密度多低于同层无受累区域密度 等。MRI平扫显示腹壁脂肪层呈T1WI稍 低、T2WI脂肪抑制序列高信号，肌肉-肌 间隙密度增高且边界模糊；肌肉组织可 见斑点、线条、片状T1WI 稍低、T2WI脂 肪抑制序列不规则高信号影等。CT、MRI 增强扫描均表现为斑点状、线条状、片 状轻-中度异常强化。结论 CT与MRI均可 反映急性重症胰腺炎患者腹壁受累，其 影像学均具有特征性，MRI腹壁受累检出 率相对较高，临床可联合CT检查腹壁受 累情况。

Objective To investigate the clinical value of CT and MRI in reflecting abdominal wall involvement in patients with severe acute pancreatitis. Methods Seventy cases with severe acute pancreatitis were enrolled in the study. The results of ultrasound examination showed highly suspicious abdominal wall involvement.All subjects successively underwent CT and MRI examination, and the imaging data were complete. The detection rates of abdominal wall involvement were compared between CT and MRI, and the findings of CT and MRI of abdominal wall involvement in severe acute pancreatitis were analyzed. Results CT scan found 37 cases with abnormal abdominal wall density, and the detection rate of abdominal wall involvement was 52.86% while MRI scan found 40 cases with abnormal abdominal wall signal, and the detection rate of abdominal wall involvement was 57.14%. Among 70 cases, a total of 46 cases (65.71%) with abdominal wall involvement were detected by CT and MRI, and the detection rate showed no significant difference between CT and MRI (P＞0.05). CT and MRI showed that the sites of abnormal abdominal wall included unilateral and bilateral abdominal wall, and abnormal unilateral abdominal wall was common. CT scan showed increased abdominal fat layer density, blurred boundaries of muscle-fat gap and muscle tissue density lower than thedensity of the same layer without involvement. MRI scan showed that the abdominal wall fat layer showed slightly lower T1WI and T2WI fat suppression sequence high signal, increased densityand blurred boundaries of muscle-muscle gap, with presence of spot-like, line and patchy T1WI slightly lower, T2WI fat suppression sequenceirregular high signal shadow. CT and MRI enhanced scans showed patchy, linear and patchy mild to moderate enhancement. Conclusion Both CT and MRI can reflect abdominal wall involvement in patients with severe acute pancreatitis, and the imaging findings are characteristic. The detection rate of MRI for abdominal wall involvement is relatively higher, and it can be used combined with CT for detection of abdominal wall involvement.