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目的:研究急性坏死性胰腺炎的CT 表现和临床意义。材料和方法:回顾了早期(48 小时内) 经CT 检查并经多次CT 随访的坏死性胰腺炎,临床和血尿淀粉酶均符合的50 例患者,平扫及团注法增强扫描,观察胰腺密度、体积、包膜改变,积液范围及程度,特别注意了脾出血和脾血管受侵的危重征象。结果:急性坏死性胰腺炎早期CT 图像均能做出明确诊断。多部位胰腺坏死及胰周积液超过2 个部位以上是产生并发症和临床预后较差的指征。结论:在坏死性胰腺炎诊断中CT 是最直观和显示受侵部位最清晰的影像手段,早期CT 扫描,适时CT 随访是估价临床预后有力依据之一,脾血管受侵是引起死亡的重要并发症。
Objective: To study the CT manifestations and clinical significance of acute necrotizing pancreatitis. MATERIALS AND METHODS: Fifty patients with early-stage (within 48 hours) CT necropsy after follow-up of CT scan, clinical and hematuria amylase were enrolled. Echocardiography and bolus enhanced scanning were performed to observe the pancreas Density, volume, capsule changes, extent and extent of effusion, with particular attention to spleen bleeding and spleen and blood vessels affected by the critical signs. Results: Early CT images of acute necrotizing pancreatitis can make a definite diagnosis. Multi-site pancreatic necrosis and peripancreatic fluid more than two sites above is an indication of complications and poor clinical prognosis. Conclusions: CT is the most direct imaging method in the diagnosis of necrotizing pancreatitis and shows the most clear image of the affected site. Early CT scan and proper CT follow-up are one of the strong evidences to evaluate the clinical prognosis. Splenic and vascular invasion is the important cause of death disease.