CT與MRI在急性胰腺炎診斷中的價值對比研究

[摘要]目的 探討CT與MRI在急性胰腺炎（AP）診斷中的價值比較。 方法 選擇我院168例臨床高度懷疑急性胰腺炎患者，為明確其診斷，同時行CT與MRI檢查，根據檢查方法將其分為CT檢查組與MRI檢查組。比較兩組的影像表現、靈敏度、特異度、陽性預測值、陰性預測值、診斷正確率之間的差異。 結果 CT及MRI下胰腺炎的表現，在確診的病例中，CT組診斷符合率為96.00%，MRI組診斷符合率為98.67%。CT、MRI在診斷急性胰腺炎中具有一致性，CT診斷急性胰腺炎的診斷準確率、靈敏度、特異度、陽性預測值與陰性預測值分別為：92.86%、96.00%、66.67%、96.00%與66.67%；MRI診斷急性胰腺炎的診斷準確率、靈敏度、特異度、陽性預測值與陰性預測值分別為：95.24%、98.67%、77.78%、97.37%與87.50%。 結論 MRI檢查的靈敏度與特異度及診斷準確率均高于CT檢查，值得臨床推廣使用。

[關鍵詞] CT；MRI；急性胰腺炎；診斷

[中圖分類號] R576 [文獻標識碼] B [文章編號] 2095-0616（2013）13-121-03

Comparative study on the value of CT and MRI in the diagnosis of acute pancreatitis

LI Shengkai ZHU Wenbiao

The People's Hospital of Meizhou City in Guangdong Province，Meizhou 514031，China

[Abstract] Objective To discuss comparative study on the value of CT and MRI to diagnose acute pancreatitis. Methods 168 clinical highly suspected acute pancreatitis were selected and to clarify the diagnosis，all patients were examined by CT and MRI. Imaging demonstrated sensitivity specific degrees positive predictive value，negative predictive value diagnosis accuracy were compared. Results CT and MRI in the diagnosis of acute pancreatitis have consistency，diagnostic accuracy of CT in the diagnosis of acute pancreatitis，sensitivity，specific，positive predictive value and negative predictive value were 92.86%，96.00%，66.67%，96.00%，66.67%，hile Diagnostic accuracy of MRI in the diagnosis of acute pancreatitis，sensitivity，specific，positive predictive value and negative predictive value were 95.24%，98.67%，77.78%，97.37%，87.50%. Conclusion CT and MRI in the diagnosis of acute pancreatitis have important clinical diagnostic value，it is very important significance in clinical treatment for the early diagnosis and guidance of acute pancreatitis.

[Key words] CT；MRI；Acute pancreatitis；Diagnosis

急性胰腺炎是一種由于胰腺酶病變后致使胰腺的排泄、血液循環、分泌等發生功能的異常變化后致使胰腺的自我消化甚至是組織的受損。急性胰腺炎的診斷標準要綜合患者的臨床癥狀、影像學及實驗室的相關檢查等病史資料，其中，CT與MRI檢查在急性胰腺炎的影像學診斷與臨床分型中起著非常重要的意義[1-3]，現報道如下。

1 資料與方法

1.1 一般資料

選取我院2011年4月～2013年4月的臨床高度疑診為急性胰腺炎的患者168例，入選標準為：經臨床癥狀與實驗室檢查高度懷疑急性胰腺炎的患者，排除標準：危重的心肺疾病、休克、高血壓患者且血壓控制不良、腦出血、患有精神疾病，肝腎衰竭等患者。……