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目的探讨急性胰腺炎(AP)时胃裸区受累的多层螺旋CT(MSCT)的特点。方法回顾性分析59例AP患者的MSCT资料,重点观察胃裸区受累的MSCT表现特征、受累途径,分别统计不同Balthazar CT分级(Balthazar分级)患者胃裸区受累的发生率。结果 CT表现为胰周肾旁前间隙炎性病变与胃裸区炎性病变相连续39例;胰周肾旁前间隙病变与肾前筋膜间平面炎性病变相连续、后者再与胃裸区相连续8例;胰周肾旁前间隙炎性病变和肾前筋膜间平面炎性病变、共同累及胃裸区2例。胃裸区受累表现为胃裸区增宽,正常的脂肪密度影被水肿、浸润增厚的弥漫性或局限性软组织密度影或液性密度影所替代。CT分级为C、D、E级者胃裸区受累发生率依次为50.0%、68.4%、94.4%,两两比较,P均<0.05。结论 MSCT可以准确、全面地显示胃裸区受累的解剖细节,胃裸区受累情况可在一定程度上反映AP的严重程度。
Objective To investigate the characteristics of multi-slice spiral CT (MSCT) involved in gastric mucosa in acute pancreatitis (AP). Methods The MSCT data of 59 patients with AP were retrospectively analyzed. The characteristics of MSCT involvement in gastric bare area were observed. The incidence of gastric involvement in different Balthazar CT grades was calculated. Results The CT manifestations of the peritumoral anterior renal interstitial inflammatory lesions and gastric naked area inflammatory lesions in 39 consecutive cases; peritoneal anterior patellofemoral space lesions and prerenal fascia interplastic inflammatory lesions were continuous, the latter with the gastric bare area 8 consecutive cases; peripancreatic renal paravalvular inflammatory lesions and anterior renal interstitial inflammatory lesions, involving the common gastric area in 2 cases. Involved in the performance of the nude area of the gastric naked area widened, the normal fat density shadow edema, thickening of the diffuse infiltration or limitations of soft tissue density or liquid density instead. The incidence of gastric involvement in patients with CT grade C, D, E grade was 50.0%, 68.4%, 94.4% respectively, with any pairwise comparison (all P <0.05). Conclusion MSCT can accurately and comprehensively display the anatomical details involved in the gastric bare area. The involvement of the gastric bare area may reflect the severity of AP to some extent.