目的 探析螺旋CT在急性胰腺炎 诊断及病情分级中的应用价值。方法 选 择我院2013年8月-2015年8月所收治的 110例急性胰腺炎患者作为研究对象进行 回顾性分析，参照Balthazar CT平扫形 态评分进行形态改变评分，结合坏死情 况予以CTSI评分，并据此判定病情严重 程度。结果 轻度与中度患者住院时间分 别为(9.6±2.3)d、(21.5±5.4)d，无 死亡病例，预后良好；重度患者住院时 间达(40.2±6.8)d，死亡率为20.0%， 预后与轻度及中度患者相比明显更差(P ＜0.05)。急性胰腺炎患者早期表现以 胰腺体积增大、胰管扩张为主，CT值约 为30HU，密度比正常胰腺低。随病情加 重，胰腺周围脂肪间隙逐渐消失、肾前 筋膜增厚，胰腺轮廓模糊。胰腺出现炎 性水肿或坏死时均表现为胰腺低密度影 (CT值10-20HU)。水肿区增强扫描后可有 轻度强化，坏死区可无强化，仅表现为 低密度。坏死性胰腺炎患者均可见气液 平面，出血则表现为高密度。结论 急性 胰腺炎临床表现复杂、病情进展快，螺 旋CT的应用可准确显示胰腺病灶部位、 病变范围及程度，了解病灶变化情况， 并通过对急性胰腺炎的定性诊断、分型 为临床治疗提供依据，使患者可尽早获 得有效治疗，避免病情进展，促进预后 的改善。

Objective To explore application value of spiral CT in the diagnosis and disease classification of acute pancreatitis. Methods A retrospective analysis of clinical data was carried out in 110 patients with acute pancreatitis treated in our hospital from August 2013 to August 2015 who were selected as the research objects, Balthazar CT plain scanning was used as the reference to carry out morphological change scores, CTSI scores was carried out combined with necrosis, and determined disease severity. Results Hospitalized time of mild and moderate patients were (9.6±2.3)d, (21.5±5.4) days, no deaths, good prognosis; hospitalization time of severe patients was (40.2±6.8) days, death rate was 20.0%, prognosis was significantly worse than mild and moderate patients (P<0.05). Main performances of patients with acute pancreatitis in early stage were pancreatic volume increase, pancreatic duct dilation, CT value was about 30HU, density was lower than normal pancreas. With disease aggravated, fatty space near pancreas dribbled away, prerenal fascia bodiness, pancreatic profile blur. Performances of edema calidum or necrosis occurred in pancreas were pancreas low density shadow (CT value 10~20HU). After enhancement scanning, mild enhancement occurred in edema zone, no enhancement in necrotic area, performance was low density. Air fluid level could be seen in patients with necrotic pancreatitis, performance of haemorrhage was high density. Conclusion Clinical manifestation of acute pancreatitis is complicated, progression disease is fast, application of spiral CT can display pancreatic lesion location, extent of disease and degree accurately, understand lesion absorption, degeneration condition, provide basis for clinical treatment via qualitative diagnosis and somatotype of acute pancreatitis, so that patients can get effective treatment as early as possible, avoid progression disease, promote prognosis improvement.