摘要
目的:评价CT在胰腺损伤早期诊断中的价值。方法:对155例手术病理或复查证实急性胰腺炎的CT资料进行回顾性分析,按Balthazar急性胰腺炎CT分组分为A、B、C、D、E五级的各组病例分别与血尿淀粉酶进行比较。所有病例均术前行腹部CT平扫,其中6例还行增强扫描。结果:CT表现胰腺肿胀136例(87.74%),胰腺渗液105例(67.74%),胰腺坏死51例(32.90%),假性囊肿形成53例(34.19%),合并感染或脓肿形成23例(14.84%)。血尿淀粉酶与CT比较:A级14例(9.03%)血尿淀粉酶轻度升高,B级36例(23.23%)中度升高,C级31例(20.00%)显著升高,D级22例(13.19%)血尿淀粉酶趋向下降,E级53例(34.19%)显著下降。结论:CT早期检查可以准确的反映B、C、D、E各级的病理变化,复查结果提示病理转归,所以,CT检查应作为急性胰腺炎诊断的主要手段。而A级患者,诊断时应将CT检查结果与血尿淀粉酶结果综合分析。CT对急性胰腺炎的诊断优于US。作者认为CT对急性胰腺炎的早期诊断有重要价值,应作为诊断急性胰腺炎的首选方法。
Objective：To evaluate the clinical value of early CT examination in diagnosis of acute pancreatitis Methods：The CT appearances of acute pancreatitis in 156 cases confirmed by surgical and pathological findings or follow up were analyzed retrospectively. All patients with acute pancreatitis were divided into A,B,C,D and E five grades based on Balthazar CT grades in which the CT grades were compared with the hematuria amylase. All cases underwent CT plain scans of the abdomen and 6 cases underwent contrast enhanced scans preoperatively. Results：Pancreatic parenchyma showed enlargement in 136（87.2%） patients,enlarged peripancreatic drainage in 105（67.3%） ,pancreatic necrosis in 51（32.6%） ,formation of pseudocyst in 53（34%） and complicated infection or ormation of abscess in 23（14.7%） . CT findings were compared with the hematuria amylase：grade A had 14 cases（8.97%） with hematuria slight increased amylase,grade B had 36 cases（23.07%） with moderately increased,grade C had 31 cases（19.23%） with appreciably increased,grade D had 22 cases（14.10%） with downward trend and grade E had 53 cases（33.97%） with appreciably decline. Conclusion：Early CT examination can accurately reflect the histopathological changes with B,C,D and E grade,and recheck imagines can suggest pathological features and prognosis,so CT examination was emphasized for finding and diagnosis of acute pancreatitis. Moreover,cases of grade A should be diagnosed on the basis of comprehensive analysis of CT findings and hematuria amylase. The CT in the diagnosis of acute pancreatitis is superior to ultrasonic,which is a better method in the diagnosis of acute pancreatitis,and should be used as a primary examination.
出处
《甘肃医药》
2011年第8期458-461,共4页
Gansu Medical Journal
