急性胰腺炎胰腺微循环损害的MSCT灌注成像  

MSCT Perfusion Imaging of Pancreatic Microcirculatory Impairment in Acute Pancreatitis

作　　者：杨斌[1] 陈文辉[1] 王楚雄[1] 周建[1] 周合山[1] 陈晓英[1] 俞一歆[1] 单艳娜[1] 

机构地区：[1]杭州市第一人民医院放射科,杭州310006

出　　处：《放射学实践》2009年第7期744-749,共6页Radiologic Practice

摘　　要：目的:探讨急性胰腺炎胰腺微循环损害的特点及MSCT灌注成像的临床应用价值。方法:采用急性胰腺炎的临床分级和Balthazar CT分级标准,将入院后48h内的69例急性胰腺炎患者分为轻症组(MAP)42例(CT分级为A级16例,B级9例,C级17例)和重症组(SAP)27例(CT分级为D级11例,E级16例),以12例无胰腺疾病的胸部CT检查患者作为对照组。所有患者均行MSCT胰腺灌注扫描,测量参数包括胰腺的时间-密度曲线(TDC)以及灌注参数:血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS)。结果:急性胰腺炎时胰腺TDC上升斜率较小,峰值降低。正常胰腺、MAP和SAP三组中胰腺的BV值依次下降,且相互间差异均有显著性意义(P<0.05);SAP组胰腺BF、BV值均低于MAP组,MTT、PS均增高,差异有显著性意义(P<0.05)。MAP组中CT分级为A级者较正常胰腺组BF值增高,B、C级较正常胰腺组BF、BV减低,PS增高(P<0.05)。结论:急性胰腺炎患者的胰腺血流灌注状态与其严重程度关系密切,它呈先升后降的趋势。MSCT灌注成像可以定量评价胰腺的微循环状况,对急性胰腺炎的早期分级有潜在应用价值。Objective：To investigate the characteristics of microcireulatory impairment in acute pancreatitis and the value of MSCT perfusion imaging in clinical application. Methods： According to the clinical diagnostic criteria and Balthazar plain CT scan score, 69 acute pancreatitis patients within 48 hours of hospitalization including 42 cases of mild acute pancreatitis （MAP,CT grade A=16,B=0,C=17） and 27 cases of severe acute pancreatitis （SAP,CT grade D=ll,E 16） as well as 12 control patients taking chest CT but without pancreatic disease were recruited in the study. MSCT perfusion imaging of pancreas were performed for all patients. Those parameters of pancreatic perfusion,including time density curve （TDC）, blood flow （BF）, blood volume （BV） , mean transit time （MTT） and surface permeability （PS） were measured. Results：The maximum ascend inclination rate and peak value of TDC of pancreas were lower in acute pancreatitis than that in controls. The pancreatic BV of the control group, MAP and SAP descent successively, significant statistical differences were existed （P〈0.05）. Pancreatic BF,BV of SAP were significantly lower than that of MAP, yet MTT and PS were higher, with significant statistical difference （P〈0.05）. The BF of MAP patients with CT grade A were higher than that in control group, yet the BF and BV in patients with CT grade B and C were lower and PS were higher than those in controls with significant statistical differences （P〈0.05）. Conclusion：The patterns of pancreatic blood perfusion in acute pancreatitis were in close relationship with the severity. The trend was ascended firstly then declined. The degree of micro-circulation of pancreas could be quantitatively evaluated by MSCT perfusion imaging, which showed potential clinical value in the gradation of early acute pancreatitis.

关 键 词：急性胰腺炎 灌注成像 体层摄影术 X线计算机 

分 类 号：R576[医药卫生—消化系统] R816.5[医药卫生—内科学]