目的 探讨多层螺旋CT、超声联 合血淀粉酶检测在重症监护室(ICU)重症 急性胰腺炎诊断中的应用价值。方法 将 2017年5月至2018年5月于我院就诊治疗的 94例重症急性胰腺炎患者作为研究对象， 收集所有患者性别、年龄、疾病和临床 检查指标以及影像学资料，确诊为重症急 性胰腺炎后均转入ICU进行治疗，分析不 同检查方法对诊断重症急性胰腺炎的灵敏 度和特异性差异。结果 多层螺旋CT+超声 +血淡粉酶检查诊断重症急性胰腺炎的灵 敏度和特异性分别为92.6%和91.2%，均显 著高于多层螺旋CT检查、超声和血淀粉酶 三种检查方法单独检查以及其两两结合检 查(P<0.05)；94例重症急性胰腺炎经超声 检查示78例为水肿型，主要表现为胰腺弥 漫性肿大，绝大部分患者胰腺实质回声表 现为均匀减弱。在CT平扫中可见胰腺明显 增大，在胰体尾部尤为显著，且胰腺周围 可见少许渗出影，而在增强扫描图像中可 见动脉期、静脉期和延迟期均未见胰腺增 粗、明显异常强化。结论 多层螺旋CT检 查可准确的显示胰腺的解剖学位置、反映 其病变严重程度，且结合超声和血淀粉酶 共同检查诊断重症急性胰腺炎的灵敏度和 特异性均最高，更具有临床价值。

Objective To explore the application value of multi-slice spiral CT and ultrasound combined with blood amylase examination in the diagnosis of severe acute pancreatitis in intensive care unit (ICU). Methods A total of 94 patients with severe acute pancreatitis who were treated inour hospital from May 2017 to May 2018 were enrolled in the study. All patients' gender, age ,indicators of clinical examination and imaging data were collected. According to the data, all patients were diagnosed as severe acute pancreatitis and then transferred to the ICU for treatment. The sensitivity and specificity of different methods for the diagnosis of severe acute pancreatitis were analyzed. Results The sensitivity and specificity of multi-slice spiral CT and ultrasound combined with blood amylase examination for the diagnosis of severe acute pancreatitis were 92.6% and 91.2%, respectively, which were significantly higher than those of the multi-slice spiral CT examination, ultrasound and blood amylase examination alone and those in pairs(P<0.05). In 94 patients with severe acute pancreatitis diagnosed by ultrasound examination, 78 cases were edematous, mainly charactering diffuse enlargement of the pancreas. In most patients, the parenchymal echo of the pancreas showed a uniform attenuation. In the plain scan of the CT, the pancreas was significantly enlarged, especially in the tail of the pancreas, and a little exudation was observed around the pancreas. After enhanced contrast, no obvious and abnormal enhancement of pancreatic thickening was observed in the arterial phase, venous phase and delayed phase. Conclusion Multi-slice spiral CT examination can display the anatomical location of the pancreas better and reflect the pathogenesis and severity of lesions. Combined with ultrasound and blood amylase, the sensitivity and specificity for the diagnosis of severe acute pancreatitis are the highest and more valuable in clinical.