急性胰腺炎累及小网膜腹膜下间隙MSCT表现及其与CT分级的相关性研究  

The Correlative Study between CT Pathological Classification and CT Manifestations in Acute Pancreatitis Involved Subperitoneal Space of Lesser Omentum

作　　者：刘凤杰[1] 辛顺宝[1] 焦自梅[1] 王锡臻[1] 董鹏[1] 李静 

机构地区：[1]潍坊医学院附属医院影像中心,261031 [2]青州市立医院云门山分院

出　　处：《天津医药》2011年第11期996-998,共3页Tianjin Medical Journal

基　　金：山东省优秀中青年科学家科研奖励基金资助项目(项目编号:2005BS03010);山东省教育厅资助项目(项目编号:J06L24);潍坊医学院2009年度大学生科技创新基金项目(项目编号:KX2009011);山东省医药卫生科技发展计划项目(项目编号:2011HZ112)

摘　　要：目的:探讨急性胰腺炎(AP)累及小网膜腹膜下间隙的多层螺旋CT(MSCT)表现及其与Balthazar CT分级的相关性。方法:分析经手术病理和(或)临床实验室证实的58例AP患者的MSCT资料,其中19例用64排螺旋CT扫描,39例用16排螺旋CT扫描,采用自动高压注射器经前臂静脉注射对比剂,扫描膈顶至盆底。多平面重建后观察肝十二指肠韧带及肝胃韧带的受累(韧带增厚、密度增高及血管边缘模糊等)情况,并记录各个患者的Balthazar CT分级情况。结果:(1)58例中,Balthazar CT分级C级4例,D级18例,E级36例;肝十二指肠韧带受累45例,肝胃韧带受累50例。(2)肝十二指肠韧带与肝胃韧带受累表现为韧带水肿增厚、液体积聚及密度增高。(3)AP肝十二指肠韧带和肝胃韧带受累的发生率与其Balthazar CT分级有关(P<0.05)。结论:MSCT可充分显示急性胰腺炎累及小网膜的细节;小网膜的受累情况能从一定程度上反映急性胰腺炎的严重程度。Objective：To explore the correlation between manifestations of multi-slice spiral CT （MSCT） and Balthazar CT classification in acute pancreatitis （AP） involved subperitoneal space of lesser omentum.Methods：MSCT images of fifty-eight patients with acute pancreatitis proved by surgery and/or clinical and laboratory findings were retrospectively analyzed.CT examinations were performed on a 64-MSCT scanner in 19 patients and on a 16-MSCT scanner in 16 patients.The automatic high pressure injector was used to inject contrast material through forearm vein.The scan scope was set between the level of diaphragm roof and pelvic floor.After multi-planar reconstruction,the MSCT findings of AP involved subperitoneal space of lesser omentum were observed and the Balthazar CT classification was recorded.Results：（1）In fifty-eight patients,four cases belonged to C grade,eighteen cases belonged to D grade and thirty-six cases belonged to E grade by Balthazar＇s criterion.Hepatoduodenal ligament was involved in forty-five cases,and hepatogastric ligament was involved in fifty cases.（2）The hepatoduodenal ligament and hepatogastric ligament involvement showed edema,thickening,fluid collection and density increasing.（3）There were significant differences between the incidence rate of hepatoduodenal ligament and hepatogastric ligament involvement and Balthazar CT classification （P 0.05）.Conclusion：MSCT can sufficiently demonstrate the details of acute pancreatitis involved subperitoneal space of the lesser omentum.The hepatoduodenal ligament and hepatogastric ligament involvement can reflect the severity of acute pancreatitis.

关 键 词：急性病 胰腺炎 胰腺炎 急性坏死性 网膜 结肠系膜 体层摄影术 体层摄影术 X线计算机 

分 类 号：R576[医药卫生—消化系统]