目的 分析急性坏死性胰腺炎CT 增强扫描表现及其诊断价值。方法 回顾 性分析2016年10月-2018年5月我院收治 的56例急性坏死性胰腺炎患者的临床资 料，均于发病3d内行CT增强扫描，分析其 影像学表现及诊断价值。结果 ①56例患 者Baltha法CT分级：A级7例，B级7例，C 级13例，D级20例，E级9例。②影像学表 现：胰腺体积局限性或普遍性增大、肿 胀，密度不均匀，可见点状或斑片状分布 的低密度区，或低密度区夹杂伴高密度 影；胰腺形态不规则，强化均匀，伴或不 伴斑片状高密度影及密度降低区，且胰腺 脂肪周围轮廓模糊，脂肪层消失；增强扫 描中胰腺呈明显强化，坏死部分无明显强 化区，正常组织明显强化。③肝脏CT值降 低组Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级CT值均显著 低于肝脏CT值正常组，差异有统计学意义 (P<0.05)。结论 CT增强扫描对急性坏死 性胰腺炎具一定诊断价值，可指导后续治 疗方案的制定及预后改善。

Objective To analyze the findings of CT enhanced scan of acute necrotizing pancreatitis and their diagnostic value. Methods The clinical data of 56 patients with acute necrotizing pancreatitis who were admitted to the hospital from October 2016 to May 2018 were retrospectively analyzed. CT enhanced scan was performed within 3 days after onset, and the imaging findings and diagnostic value were analyzed. Results The CT grade of 156 patients with Baltha method showed 7 cases of grade A, 7 cases of grade B, 13 cases of grade C, 20 cases of grade D and 9 cases of grade E. Imaging findings included pancreatic volume showing local or general increase and swelling, inhomogeneous density, visible spotted or patchy distribution of low-density zone or increased density shadows in decreased density zone, irregular shape of the pancreas, homogeneous enhancement with or without patchy high-density shadow density-reduction zone, blurred outline of fat adjacent to pancreas and fat layer disappearing. The enhanced scan of pancreas showed obvious enhancement, without obvious enhancement zone in necrotic part and with obviously enhancement of normal tissue. The CT values of grade I, grade II, grade III and grade IV in the decreased liver CT value group were significantly lower than those in the normal liver CT value group (P<0.05). Conclusion CT enhanced scan is of certain diagnostic value for acute necrotizing pancreatitis, which can guide the development of follow-up treatment plan and improve the prognosis.