石玲

【摘要】 目的：探討电子计算机断层扫描（CT）、磁共振成像（MRI）及磁共振水分子扩散加权成像（DWI）在胰腺炎肝损害患者中的应用效果。方法：选择2018年4月-2020年1月于本院诊治的胰腺炎肝损害患者72例为研究对象，均经临床检查最终确诊，确诊前分别行CT、MRI、DWI检查，分析CT、MRI、DWI在胰腺炎肝损害患者中的诊断效果。结果：CT检查确诊胰腺炎肝损害患者64例，诊断符合率为88.89%。41例CT扫描肝脏为低密度，平均CT值为（37.6±3.2）HU;23例CT值为（15.6±1.6）HU。MRI检查确诊胰腺炎肝损害患者68例，诊断符合率为94.44%。患者均行MRI同反相位检查，40例in-phase呈高信号，24例out-phase呈低信号，4例患者T2WI脂肪抑制呈等信号。DWI检查确诊胰腺炎肝损害患者71例，诊断符合率为98.61%，患者平均ADC值为（1.06±0.43）×10-3 mm2/s。结论：CT、MRI及DWI用于胰腺炎肝损害患者中能获得较高的检出率，能为临床诊疗提供影像学依据。

【关键词】 电子计算机断层扫描 磁共振成像 磁共振水分子扩散加权成像 胰腺炎 肝损害

Preliminary Study of CT， MRI and DWI on Liver Damage in Pancreatitis/SHI Ling. //Medical Innovation of China， 2021， 18（24）： -185

[Abstract] Objective： To investigate the effects of computed tomography （CT）， magnetic resonance imaging （MRI） and Magnetic resonance water molecular diffusion weighted imaging （DWI） in patients with pancreatitis and liver damage. Method： A total of 72 patients with pancreatitis and liver damage diagnosed in our hospital from April 2018 to January 2020 were selected as the study subjects. All patients were confirmed by clinical examination. CT， MRI and DWI examinations were performed respectively before diagnosis， and the diagnostic effect of CT， MRI and DWI in patients with pancreatitis and liver damage were analyzed. Result： CT examination confirmed pancreatitis liver damage in 64 cases， the diagnostic coincidence rate was 88.89%. The liver density was low on CT scan in 41 patients， with a mean CT value of （37.6±3.2） HU， the CT value of 23 cases was （15.6±1.6） HU. MRI examination confirmed pancreatitis in 68 patients with liver damage， the diagnostic coincidence rate was 94.44%. All patients underwent MRI in the same and opposite phase， and 40 patients showed high signal in in-phase， 24 patients showed low signal in out-of-phase， and 4 patients showed isosignal in T2WI fat inhibition. There were 71 patients with pancreatitis liver damage confirmed by DWI， the diagnostic coincidence rate was 98.61%， and the average ADC value was （1.06±0.43） ×10-3 mm2/s. Conclusion： CT， MRI and DWI can obtain high detection rate in patients with pancreatitis liver damage， which can provide imaging basis for clinical diagnosis and treatment.

[Key words] Computed tomography Magnetic resonance imaging Magnetic resonance water molecular diffusion weighted imaging Pancreatitis Liver damage

First-author’s address： The Third Affiliated Hospital of Gannan Medical College， Ganzhou 341000， China

doi：10.3969/j.issn.1674-4985.2021.24.045

胰腺炎是胰腺由于胰蛋白酶自身消化引起的慢性疾病，导致胰腺水肿、充血或坏死，临床多表现为腹痛、恶心呕吐、腹胀等，部分患者伴有淀粉酶升高[1]。既往研究表明，胰腺炎好发于高脂血症、高钙血症人群中[2]，常见病因包括酗酒、胆道疾病、暴食暴饮及手术与损伤等，影响居民健康生活。从人体解剖学角度来说，胰腺组织与人体肝脏邻近，通过静脉、血管等相互连接[3]。因此，胰腺炎患者发病后常伴有不同程度肝损害，能加重病情发生、发展。胰腺炎所致肝损害机制复杂，可能与以下因素有关，（1）导致胰腺炎病因和对胰腺有损害的因素引起的肝脏损害;（2）胰腺炎患者释放大量炎性因子，可激活机体内的多种生物酶释放大量有害物质，进入肝脏引起肝损伤;（3）休克、肝脏缺血及氧自由基等均能引起肝脏损害[4]。……