胰腺损伤的多层螺旋CT表现  

MSCT findings of traumatic pancreatic injury

作　　者：胡晓峰 邓克学 许实成 刘兵[1] 戴刚 HU Xiaofeng;DENG Kexue;XU Shicheng;LIU Bing;DAI Gang(Department of Radiology ,the First Affiliated Hospital of USTC ,Division of Life Sciences and Medicine ,University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院放射科,安徽合肥230001

出　　处：《实用放射学杂志》2018年第12期1882-1885,1888,共5页Journal of Practical Radiology

摘　　要：目的探讨多层螺旋CT(MSCT)对胰腺损伤的诊断价值。方法回顾性分析本院收治的38例胰腺损伤思者的临床及MSCT检查资料。根据胰腺损伤的深度分为浅表伤和深部伤;浅表伤为血肿或裂伤小于胰腺厚度的50%,深部损伤为血肿或裂伤超过胰腺厚度的50%。结果38例患者中,手术治疗32例,非手术治疗6例;胰腺浅表伤20例,胰腺深部伤18例。CT总体诊断符合率89.5%(34/38),深部伤诊断符合率为100%(18/18),同时深部伤中均发现主胰管损伤。5例胰腺损伤经CT增强扫描及后处理技术发现,4例浅表伤CT检查元明显阳性发现。胰腺损伤CT表现为胰腺内或周围血肿16例,胰腺撕裂伤或断裂伤17例,胰腺挫伤10例,胰腺假性囊肿11例,胰管扩张3例,创伤性胰腺炎20例,4例发生胰周感染,形成脓肿。其中血肿为胰腺损伤的早期表现(7d内),随后可演变为撕裂伤或断裂伤及假性囊肿。胰腺损伤发生在胰头部10例,胰头颈部1例,胰颈部10例,胰颈体部1例,胰体部2例,体尾部7例,胰尾部7例,其中胰腺挫伤以胰头部多见(8/10,80%)。另外单纯胰腺损伤19例,复合伤19例。结论胰腺深部损伤CT诊断符合率高,且均发现主胰管损伤;胰腺损伤的CT表现与时间、损伤部位及损伤程度有关;CT增强及后处理技术可提高胰腺损伤的诊断符合率。Objective To assess the value of MSCT in the diagnosis of traumatic pancreatic injury.Methods The clinical and examination data of 38patients with pancreatic injury admitted to our hospital were retrospective reviewed.Radiographic pancreatic injuries were classified as superficial or deep lesions,according to the depth of the injury to pancreas.Superficial lesions were defined as the hematomas or lacerations <50%of thickness of pancreas,deep lesions as the hematomas or lacerations>50%of thickness of pancreas.Results In 38patients,32patients underwent operative treatment,and other 6patients underwent nonoperative treatment,including 20patients with superficial injury and 18patients with deep injury.The overall diagnostic coincidence rate of CT was 89.5%(34/38),and diagnostic coincidence rate for deep injury was 100^(18/18]with injury of the main pancreatic duct.Five cases of pancreatic injury were detected by CT enhancement and post-processing technique,and CT examination was considered negative in 4cases of superficial injury.CT showed intrapancreatic or peripancreatic hematomas in 16cases,pancreatic tear or laceration in 17cases,pancreatic contusion in 10cases, peripancreatic pseudocyst in 11cases,dilation of the main pancreatic duct in 3cases,traumatic pancreatitis in 20cases and peripancreatic infection with abccess in 4cases.Pancreatic injury presented as pancreatic or peripancreatic hematomas in early stage (within 7days)and subsequently evolved into pancreatic tear or laceration and pseudoeyst.Pancreatic injury was located in the pancreatic head in 10cases,both in pancreatic head and neck in 1case,in pancreatic neck in 10cases,both in pancreatic neck and body in 1case,in pancreatic body in 2cases,both in pancreatic body and tail in 7cases and in pancreatic tail in 7eases.Pancreatic contusion was mainly located in pancreatic head (8/10, 80%).19cases of simple pancreatic injury and 19complex ones were showed in this study.Conclusion The diagnostic coincidence rate of CT for deep pancreatic injury is high with

关 键 词：胰腺 损伤 计算机体层成像 

分 类 号：R576[医药卫生—消化系统] R814.42[医药卫生—内科学]