论文部分内容阅读
目的通过急性胰腺炎(AP)的临床观察结合胰腺磁共振灌注成像(MRP)观察AP时胰腺血流变化及其与胰腺炎严重度的关系。方法前瞻性研究并记录AP患者入院72h内APACHEⅡ积分、全身炎症反应综合征(SIRS)积分、Binder积分和C反应蛋白值。将AP患者按病情轻重分为重症AP组(SAP组,15例)和轻型AP组(MAP组,17例),19例非AP志愿者作为对照组,三组均作MRP检查。SAP组患者治疗后2周再次评估上述指标,其中12例患者复查MRP。所有病例均在团注Gd-DTPA0.2mol/kg后行横轴位同层快速扰相梯度回波序列扫描(FSPGR),获得胰头、体尾部各自时间-信号曲线图,通过Perfxproject软件计算三组病例胰头、体尾部最大增强率值和斜率值。结果①SAP组胰头、体尾部最大增强率值、斜率值显著低于MAP组(P<0.05)。②SAP组治疗前后对照,其最大增强率值、斜率值变化差异无统计学意义(P>0.05)。③MAP组值较正常对照组稍低,但差异无统计学意义(P>0.05)。结论MRP是一种比较客观反映胰腺血流情况的无创影像学检查手段。对AP严重度的评判有一定价值。
Objective To observe the changes of pancreatic blood flow and its relationship with the severity of pancreatitis by clinical observation of acute pancreatitis (AP) and pancreatic magnetic resonance perfusion imaging (MRP). Methods The APACHEⅡ score, systemic inflammatory response syndrome (SIRS) score, Binder score and C-reactive protein level in AP patients were prospectively studied and recorded within 72 hours after admission. AP patients were divided into severe AP group (SAP group, 15 cases) and light AP group (MAP group, 17 cases) and 19 non-AP volunteers as control group according to severity of illness. All three groups were examined by MRP. Patients in the SAP group re-evaluated the above parameters 2 weeks after treatment, and 12 of the patients underwent MRP. All cases were given group Gd-DTPA0.2mol / kg after the horizontal axis with the same layer of rapid spoiler gradient echo sequence scan (FSPGR), were pancreatic head and tail of the respective time-signal curve, calculated by Perfxproject software three Group cases of pancreatic head and tail body maximum enhancement rate and slope value. Results ① The maximal enhancement rate and slope of pancreatic head and tail in SAP group were significantly lower than those in MAP group (P <0.05). ② Before and after treatment, the maximum enhancement rate and slope of SAP group had no significant difference (P> 0.05). ③MAP group was lower than the normal control group, but the difference was not statistically significant (P> 0.05). Conclusion MRP is a noninvasive imaging method that objectively reflects the pancreatic blood flow. Evaluation of the severity of AP has some value.