目的 探究多层螺旋CT(MSCT)诊 断急性胰腺炎腹壁受累的临床价值。方 法 选择2014年1月至2017年5月我院收治 的25例急性胰腺炎病例纳入研究。所有患 者均于发病后行MSCT检查，观察腹壁受累 MSCT表现，并进行Balthazar CT评级、急 性胰腺炎严重程度CT(CTSI)评分及临床评 分，比较CT所示腹壁受累与CT评价及临床 评价之间的相关性。结果 入组25例急性 胰腺炎患者腹壁CT改变发生率为48.00%， 主要表现为腹壁条索状影沿体壁方向平行 延伸，腹壁及肌肉间隙边界不清甚至消 失，腹壁肌肉脂肪明显增厚肿胀；相关 性分析示，急性胰腺炎患者腹壁改变与 Balthazar分级、CTSI评分、临床分级呈 正相关(r=0.521，r=0.448，r=0.396，均 P<0.05)。结论 CT所示腹壁受累可作为评 价胰腺炎严重程度的参考指标，但临床仍 应结合其他症状对病情进行综合评估。

Objective To investigate the clinical value of multi-slice spiral CT (MSCT) in the diagnosis of abdominal wall involvement in acute pancreatitis. Methods A total of 25 cases of acute pancreatitis in the hospital from January 2014 to May 2017 were included in the study. All patients were given MSCT examination after onset, the performance of abdominal wall involvement with MSCT was observed, Balthazar CT classification, acute pancreatitis severity CT (CTSI) score and clinical score were implemented. The correlations between the abdominal wall involvement showed by CT and CT evaluation, clinical evaluation were compared. Results Of the 25 patients with acute pancreatitis, the incidence of CT changes in the abdominal wall was 48.00%. The main manifestation was that the cord-like shadow of the abdominal wall paralleled extension with the body wall, the boundary of the abdominal wall and the muscle gap was unclear or even disappeared, the muscle fat of the abdominal wall was significantly thickened and swollen. Correlation analysis showed that abdominal wall changes in patients with acute pancreatitis were positively correlated with Balthazar classification, CTSI score and clinical classification (r=0.521, r=0.448, r=0.396, all P<0.05). Conclusion The abdominal wall involvement indicated by CT can be used as a reference index to evaluate the severity of pancreatitis, but it is still suitable for clinical evaluation in combination with other symptoms.