急性胰腺炎向肾周间隙扩展的MRI表现及与疾病严重程度的相关性分析  

The MRI features of perirenal space involvement in acute pancreatitis and the correlation with disease severity

作　　者：彭正伟 魏梅 蔡吉勇 欧南 Peng Zhengwei;Wei Mei;Cai Jiyong;Ou Nan(Department of Radiology,Bishan District People′s Hospital of Chongqing,Chongqing 402760,China)

机构地区：[1]重庆市璧山区人民医院放射科,重庆402760

出　　处：《中国医师进修杂志》2022年第4期356-359,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨急性胰腺炎(AP)向肾周间隙扩展的MRI表现及与疾病严重程度的相关性。方法选取2018年6月至2020年6月重庆市璧山区人民医院收治的128例AP患者作为研究对象,以超声引导下穿刺活检结果作为金标准,计算MRI诊断的准确度、灵敏度和特异度,分析AP向肾周间隙扩展MRI表现和MRI严重指数(MRSI)的相关性。结果 128例AP患者中,96例经超声引导下穿刺活检确诊为肾周间隙扩展,占75.00%,MRI诊断AP肾周间隙扩展的灵敏度为95.83%,特异度为93.75%,准确度为95.31%,阳性预测值为97.87%,阴性预测值为88.24%。AP肾周间隙受累率为75.00%(96/128),轻症、中症和重症AP肾周间隙受累率分别为52.38%(22/42)、93.62%(44/47)和7/7,42例轻症患者多数表现为胰腺本身信号异常或局灶性和弥漫性胰腺增大、增厚和肾周间隙内条索状信号异常,肾周MRI表现1级和2级;47例中症患者中多数表现为肾周间隙内斑片状信号异常,肾周MRI表现3级;7例重症患者均发现肾周间隙积液,积液呈斑片状,肾周间隙受累MRI表现分级与MRSI间有较好的相关性(r = 0.721,P<0.001);右侧肾周间隙MRI表现评分一致率为91.14%,左侧肾周间隙MRI表现评分一致率为95.38%,MRSI两者观察一致率为90.21%。结论 MRI能有效、准确诊断AP向肾周间隙扩展,MRI表现和受累率能准确反映AP的严重程度,对临床诊断和治疗AP向肾周间隙扩展患者具有积极作用。Objective To investigate the MRI features of perirenal space involvement in patients with acute pancreatitis(AP)and its correlation with disease severity.Methods A total of 128 AP patients admitted to Bishan District People′s Hospital of Chongqing from June 2018 to June 2020 were selected as study subjects.All patients were diagnosed by ultrasound guided percutaneous biopsyand the pathological diagnosis results were taken as the gold standard.The accuracy,sensitivity and specificity of MRI diagnosis were calculated to analyze the correlation between MRI features of perirenal space involvement and MRI severity index(MRSI).Results Among the 128 patients,96 patients with perirenal space involvement in AP confirmed by ultrasound guided percutaneous biopsyand the pathological diagnosis results,accounted for 75.00%.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value diagnosed by MRI were 95.83%,93.75%,95.31%,97.87%and 88.24%respectively.The involvement rate of perirenal space in AP was 75.00%(96/128),and that in mild,moderate and severe AP was 52.38%(22/42),93.62%(44/47)and 7/7,respectively.Forty-two mild patients presented abnormal signals in the pancreas,or focal and diffuse pancreatic enlargement,thickening,and abnormal streak signalabnormalities in perirenal space,perirenal MRI showed grade 1 and 2.Forty-seven patients with moderate disease showed patchy signal abnormalities in the perirenal space,and perirenal MRI showed grade 3.Seven severe patients found perirenal interstitial effusion which was patchy.There was a good correlation between MRI features grade of perirenal space involvement and MRSI(r=0.721,P<0.001).The consistent rate of MRI features score of the right perirenal space was 91.14%,the consistent rate of MRI features score of the left perirenal space was 95.38%,and the consistent rate of MRSI observation on both was 90.21%.Conclusions MRI can effectively and accurately diagnose perirenal space involvement in AP patients,MRI features and involvement rate can

关 键 词：胰腺炎 急性 磁共振成像 肾周间隙 严重程度 

分 类 号：R576[医药卫生—消化系统]