急性胰腺炎超声与CT检查的影像对比分析

1、急性胰腺炎超声与CT检查的影像对比分析        【中文摘要】目的:探讨超声及CT检查在急性胰腺炎的诊断、分型及预后评估中的价值。方法:105例急性胰腺炎患者,根据Atlanta标准分成轻重两型:轻型77例,重型28例。分别统计每位患者的年龄、性别、病因;并统计超声与CT扫描对急性胰腺炎的阳性检出率,对其在预后评估中的价值进行比较分析;分析急性胰腺炎的Ranson评分与CT评分系统之间的差异;并对急性胰腺炎的主要影响因素做多因素Logistic回回分析。结果:急性胰腺炎病情轻重分型与病因种类间无明显性差异(P0

2、.05);年龄、性别与急性胰腺炎轻重程度无相关性(P0.05);CT扫描对急性胰腺炎的阳性检出率(83/105)明显高于超声(40/105);CT平扫(20例)与CT平扫+增强扫描(85例)对急性胰腺炎的阳性检出率无明显差异(P0.05);急性胰腺炎的Ranson评分系统与CT评分系统之间存在明显性差异(P0.05);胰腺坏死、假性囊肿、小肠系膜根部积液均为影响急性胰腺炎严重程度的主要因素。结论:腹部CT扫描是诊断急性胰腺炎的重要手段,尤其是腹部增强CT扫描目前还是诊断胰腺坏死的最佳方法。胰腺坏死、假性囊肿、小肠系膜根部积液均为影响急性胰腺炎严重程度的主要因素。在AP早期(48h内)主要以Ra

3、nson评分系统为主要评估标准;而后期则主要以腹部CT扫描所见胰腺及其四周侵犯情况对AP进行预后评估。');【Abstract】 Objective:To explore the value of Ultrasound and CT in the diagnosis,classification and prognosis assessment of acute pancreatitis(AP).Methods:According to Atlanta criteria 105 cases of acute pancreatitis were collected and divided

4、 into two types:77 cases of mild acute pancreatitis(MAP) and 28 cases of severe acute pancreatitis(SAP).The etiology,age and *uality of each enrolled patients were collected.The positive rate of acute pancreatitis detected by Ultrasound and CT scan,and the prognosis assessment were analyzed.Meanwhil

5、e,the difference between Ranson score and CT scoring system of acute pancreatitis were analyzed and multivariate logistic regression analysis with influential factors for acute pancreatitis was also done.Results:No significant difference was found between severity and etiological category of acute p

6、ancreatitis(P0.05).The severe degree of acute pancreatitis had no relevance with the age and *uality(P0.05).The positive rate of acute pancreatitis detected by CT scan(79.0%) was obviously higher than that by ultrasound(38.1%).No significant difference of the positive rate was found between CT plain

7、 scan and contrast-enhanced scan(P0.05).Significant difference was found in severe acute pancreatitis detection between Ranson score and CT score(P0.05). Pancreatic necrosis,pseudocyst,and effusion of small mesenteric root were the main factors for the degree of severity in acute pancreatitis.Conclu

8、sion:Abdominal CT scan was still an important method to evaluate the acute pancreatitis, in particularly abdominal enhanced CT scan was still the best method for the diagnosis of pancreatic necrosis.Pancreatic necrosis,pseudocyst,effusion of small mesenteric root were the main factors that influenced the degree of severity in acute pancreatitis.In early period(48 hours) of acute pancreatitis,Ranson score system was the main assessment criteria,but the findings of abdom