急性胰腺炎的早期CT诊断和预测价值  

Acute Pancreatitis:Diagnostic and Prognostic Value of CT in the Early Stage

作　　者：梅其在[1] 张念察[1] 孙家邦[1] 王湘衡[1] 贾建国[1] 

机构地区：[1]首都医科大学宣武医院放射科,首都医科大学宣武医院外科

出　　处：《中华放射学杂志》1995年第11期777-780,共4页Chinese Journal of Radiology

摘　　要：作者应用ＣＴ分组和Ｒａｎｓｏｎ分类早期预测急性胰腺炎（ＡＰ）严重度。搜集住院病例８６例，重症３８例，轻度４８例。将ＡＰ的ＣＴ表现分为二组：有胰周蜂窝组织炎为重症ＡＰ（Ｉｌ组），余为轻度ＡＰ（Ｉ组）；将Ｒａｎｓｏｎ标准分三类：Ｒａｎｓｏｎ数≥３分为重症ＡＰ（２，３类），余为轻度ＡＰ（１类）。结果表明：ＣＴ分组和Ｒａｎｓｏｎ分类预测重症ＡＰ的敏感性、特异性和准确指数分别为９２．１％，９０％，８２．１％和９７．３％，５２％，４９．３％，二种预测方法的特异性和准确指数有非常显著的组间差异（Ｐ＜０．００５）。ＣＴ分组结合Ｒａｎｓｏｎ分类预测重症ＡＰ的准确指数为８３．２％，不比ＣＴ更优越多少（Ｐ＞０．０５）。研究认为胰周蜂窝组织炎作为重症ＡＰ的早期ＣＴ诊断标准，其准确性明显优于Ｒａｎｓｏｎ分类。The purpose of this paper was to find a more reliable rnethod of predicting severe cut pancreatitis(AP)by means of CT grouping(CT-G)and Ranson classification(Ranson-C).In this series of 86 cases,there were severe AP (38 cases)and mild AP (48 cases).According to CT findings,these were divided into two groups:group l without phlegmon and group 2 with phlegmon:According to Ranson scores,they were again divided into three classes (R1,R2, R3).Those with scores≤3 were classified into mild AP(Rl),the rest into severe AP (R2,R3).The resuIts shOwed that sensitivity, specificity and Youden′index of early prediction of severe AP were 92.1%, 90%,82.1%for CT-Gand 97.3%,52%,49.3%for RansonCrespectively. There was significant differ- ence between CTG and RansonC in regard to specificity and Youden′s index(P<0.005).The com- bined Youden′ s index of CT-Gwith Ranson-Cwas 83.2%,The authors concluded that peripancreat- ic phlegmon is a CT diagnostic criterion of severe AP in the early stage and the accuracy of CT-Gis much better than Ranson-C.

关 键 词：急性 胰腺炎 CT 早期诊断 预测 

分 类 号：R576.04[医药卫生—消化系统] R816.6[医药卫生—内科学]