急性胰腺炎螺旋CT增强检查临床应用.docVIP

急性胰腺炎螺旋CT增强检查临床应用 　　[摘要] 目的 探讨螺旋ＣＴ增强检查诊断急性胰腺炎的临床价值。 方法 回顾性分析临床及手术明确诊断47例急性胰腺炎患者的临床资料及螺旋ＣＴ影像表现。 结果 水肿型40例，坏死型5例，外伤型2例；胰腺体积呈弥漫性增大15例，局限性增大25例，体积无增大7例；假性囊肿2例。CT表现为肾前筋膜不同程度增厚，体积局部或弥漫增大，部分水肿型及坏死型急性胰腺炎平扫密度不均匀，增强后不均匀强化，部分患者合并胸腔及腹腔积液。 结论 多层螺旋ＣＴ检查，特别增强检查是诊断急性胰腺炎最简便、有效的方法，具有较高的临床应用价值。 　　[关键词] 急性胰腺炎；螺旋ＣＴ；增强检查；临床应用 　　[中图分类号] R445.3 [文献标识码] A [文章编号] 1674-4721（2012）03（c）-0082-02 　　 　　Clinical application of CT enhanced scan in acute pancreatitis 　　LIN Xiaoqiang1 WANG Yuan2 YI Jianwei1 WEN Xinnian1 　　1.Department of Radiology, the Hospital of Liuzhou Iron and Steel (Group) Corporation, Liuzhou 545002, China; 2.Department of Surgical, the Hospital of Liuzhou Iron and Steel (Group) Corporation, Liuzhou 545002, China 　　[Abstract] Objective To explore the diagnostic values of CT enhanced scan for acute pancreatitis. Methods Retrospective analysis of 47 patients proved by surgical pathology and clinic were examined by clinical data and CT inspection results. Results Among the 47 patients, there were 40 cases showed acute edematous pancreatitis, 5 cases showed necrosis of pancreas, and 2 cases showed traumatic pancreatitis. There were 15 patients whose volume of pancreas were diffuse enlargement, and 25 cases were localized enlargement, and 7 cases were normal; and 2 cases were pancreatic pseudocyst. The CT display that the prerenal fascia thickening, and different densities after enhancing. Also, some cases had pleural effusion and seroperitoneum. Conclusion Multislice helical CT, especially the enhanced scan is the most convenient and effective method for acute pancreatitis with high clinical value. 　　[Key words] Acute pancreatitis; Helical CT; Enhanced scan; Clinical application 　　 　　急性胰腺炎是临床最常见的急腹症之一，临床症状轻重不一，分为急性水肿型和急性出血、坏死型两种类型，后者并发症多，死亡率高。本病好发年龄为20～50岁，男性??女性多见，其病因、病理较复杂，而病程、临床表现和预后差异很大，早期明确诊断，及时治疗，能最大限度地降低死亡率。本文收集本院2009～2011年经CT检查、临床证实的47例急性胰腺炎患者的临床及影像学资料，探讨螺旋CT平扫及增强临床应用价值，报道如下： 　　1 资料与方法 　　1.1 一般资料 　　47例急性胰腺炎患者中，男34例，女13例，年龄最大91岁，最小19岁，平均54.7岁。有胆道结石、胆囊炎病历史21例，过去有