多层螺旋CT联合S-Amy、U-Amy及LPS生化指标检测对急性胰腺炎的诊断价值研究  

Diagnostic Value of Multi-slice Spiral CT Combined with Detection of Biochemical Indicator of S-Amy, U-Amy and LPS for Acute Pancreatitis

作　　者：钟燕 陈兵阳[1] ZHONG Yan;CHEN Bing-yang(Department of Critical Care Medicine, Chengdu Seventh People's Hospital, Chengdu 610000, Sichuan Province, China)

机构地区：[1]四川省成都市第七人民医院重症医学科

出　　处：《中国CT和MRI杂志》2019年第7期92-95,共4页Chinese Journal of CT and MRI

基　　金：四川省卫生厅科研课题(120545)

摘　　要：目的探讨多层螺旋CT(MSCT)联合血淀粉酶(S-Amy)、尿淀粉酶(U-Amy)及胰脂肪酶(LPS)对急性胰腺炎的诊断价值。方法取2016年1月至2018年8月我院82例急性胰腺炎患者为研究对象,收集临床及相关影像学资料,分析急性胰腺炎影像图像特征以及不同检查方法对其诊断的灵敏度和特异性。结果 MSCT+SAmy+U-Amy+LPS检查诊断急性胰腺炎的灵敏度和特异性分别为94.6%和93.2%,高于MSCT、S-Amy、U-Amy和LPS四种检查方法各单项、双项以及三项检查(P<0.05);胰腺炎中急性水肿型MSCT平扫表现胰腺体积正常,轮廓清楚或模糊,密度可未见明显改变或轻度降低,部分可见胰周积液和肾前筋膜增厚,增强示病灶呈现均匀强化;急性坏死型平扫胰腺体积明显增大,可见散在点状、斑片状或大片状低密度灶或在密度减低区夹杂密度增高影,胰腺轮廓模糊,增强扫描表现为不均匀强化,坏死区不强化,而正常组织强化。结论 MSCT+SAmy+U-Amy+LPS联合检查对急性胰腺炎的诊断具有较高的灵敏度和特异性,可更清晰的显示胰腺的组织结构,更利于临床进行定性诊断。Objective To investigate the diagnostic value of multi-slice spiral CT(MSCT combined with detection of biochemical indicator of serum amylase(S-Amy), urinary amylase(U-Amy) and pancreatic lipase(LPS) for acute pancreatitis. Methods 82 patients with acute pancreatitis who were treated in our hospital from January 2016 to August 2018 were included in the study.Clinical and related imaging data were collected to analyze the imaging characteristics of acute pancreatitis and the diagnostic sensitivity and specificity of different examination method. Results The sensitivity and specificity of MSCT combined with S-Amy, U-Amy and LPS for the diagnosis of acute pancreatitis were 94.6% and93.2%, respectively, which were significantly higher than those of the MSCT, S-Amy,U-Amy and LPS alone, and were significantly higher than those of double and triple combination examination of MSCT, S-Amy, U-Amy and LPS(P<0.05).MSCT scan of acute edematous pancreatitis showed that the volume of pancreas was normal, the contour of the pancreas was clear or blurred, there was no significant change or slight decrease in density of pancreas, and peripancreatic effusion and thickening of prerenal fascia partially were seen. Enhanced scan showed uniform enhancement of the lesion. The volume of pancreas in the scan of acute necrotizing pancreatitis can be significantly increased.And it appears as scattered, spotted or large low-density lesions. It also showed area with reduction of density was mingled with shadow of increasing density, with blurred contour. Further enhanced scanning showed uneven enhancement, the necrotic area was not strengthened, and the normal tissue was strengthened. Conclusion Joint examination of MSCT,S-Amy, U-Amy and LPS has higher sensitivity and specificity for the diagnosis of acute pancreatitis, and can clearly show the tissue of pancreas, which is beneficial to clinical qualitative diagnosis.

关 键 词：多层螺旋CT 血淀粉酶 尿淀粉酶 胰脂肪酶 重症急性胰腺炎 

分 类 号：R657.51[医药卫生—外科学]