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1、螺旋CT薄层动态增强扫描诊断急性坏死性胰腺炎的价值摘要目的：探讨螺旋CT薄层动态增强扫描在诊断急性坏死性胰腺炎中的价值。方法：对89例经手术病理证实或CT复查确诊的急性坏死性胰腺炎进行冋顾性分析。全部病例采用螺旋CT平扫并薄层动态增强扫描。管电流140mAs,层厚2mm,床速l-2mm/s,螺距1/2。结果：CT平扫确定坏死灶34例，38%。其中17例在薄层动态增强扫描时病灶数量增加，59例病灶范围扩大。全部89例经螺旋CT薄层动态增强扫描都明显显示坏死灶的范围、数量、及胰腺周围情况。结论：螺旋CT薄层动态增强扫描能明确坏死灶的部位、范围、程度及胰腺周围病理改变，对C
2、T分级、病理变化、临床诊治及预后有重要意义。关键词螺旋CT薄层增强扫描急性坏死性胰腺炎DiagnosisValueofSpiralCTThinDynamicContrastEnhancedScaninAcuteNecrosisPancreatitisWANGFengzhiDepartmentofCT/MRl,XingtaiPeoplesHospitalHebeiProvince054000,P.R.ChinaAbstract:ObjectiveTodiscussthediagnosisvalueofspiralCTthinthicknessdynamiccontras
3、tenhancedscanninginacutenecrosispancreatitis.Methods89casesofacutenecrosispancreatitiswereretrospectivelyanalyzedandcomparedwithlaparotomy.AllpatientswereexamedwithspiralCTplainscanningandthinthicknessdynamiccontrastenhancedscanning.Inplainscanningwith8mmthicknessanddynamiccontrastenhan
4、cedscanningwith2mmthickness.Tubeelectriccurrent140mAs,Bedspeedl-2mm/s,l/2pitch.ResultsInspiralCTplainscanningdefine34cases,38%,17casesamongoftheminthinthicknessdynamiccontrastenhancedscanningnecrosisplacequantityraise,59casesofthemnecrosisplacerangeenlarged.All89casesofacutenecrosisnanc
5、reatitisnecrosisplacequantity,rangeandpancreatitissurroundingwereshowedobviouslyinthinthicknessdynamiccontrastenhancedscanning•ConclusionSpiralCTthinthicknessdynamiccontrastenhancedscanningcandefiniteobviouslynecrosisplacesquantity,rangeandpancreatitissurroundingnecrosisquantity、rangean
6、dpancreatitissurroundingacutenecrosisnancreatitis,havemoreimportantinCTclassify,pathologychange,clinicaldiagnosisandcure,andprognosis.KeyWord:aSpiralCT;Thin;DynamicContrastEnhancedScan;CuteNecrosisPancreatitis急性朕腺是比较常见又很严重的急腹症，急性坏死性朕腺炎是急性朕腺炎的一种严重形式，其特征是朕腺实质坏死和朕腺周围组织的侵犯，其发病急、进展快、并发症多且死亡率
7、高，临床上缺乏特异性的诊断方法及估计预后的指标。本文通过89例急性坏死性胰腺炎的临床表现与治疗、CT严重度分级，手术及预后的分析，探讨螺旋CT2mm薄层动态壇强扫描在诊断急性坏死性胰腺炎中的价值。1.资料与方法本组89例，女40例，男49例，年龄13-73岁,平均45.6岁。发病就诊吋间最短2H,最长43H,主要临床表现为上腹部持续性疼痛、恶心、呕吐等症状，压痛、反跳痛、黄疸。实验室检查：血白细胞计数、血和乐淀粉酶、胰蛋白酶升高。手术治疗41例，死亡4例。保守治疗47例，死亡2例；使用西门子螺旋CT扫描,检查前30分钟口服2%泛影葡胺500ml,平扫
