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急性胰腺炎累及小网膜腹膜下间隙CT表现及其与CT分级的相关性研究

刘凤杰1,辛顺宝2,焦自梅2,王锡臻2,董鹏2,李静3   

  1. 1. 潍坊医学院附属医院影像中心MR室
    2. 潍坊医学院附属医院影像中心
    3. 青州市立医院云门山分院
  • 收稿日期:2011-02-16 修回日期:2011-06-29 出版日期:2011-11-15 发布日期:2011-11-15
  • 通讯作者: 董鹏

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

  • Received:2011-02-16 Revised:2011-06-29 Published:2011-11-15 Online:2011-11-15

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摘要： 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）临床实验室检查证实的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。

关键词: 急性胰腺炎, 小网膜, 腹膜下间隙, 体层摄影术, X线计算机

Abstract: Abstract Objective: To explore the correlation of 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 difference 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.

Key words: Acute pancreatitis, Lesser omentum, Subperitoneal space, Tomography, X-ray computed