ACUTE-PANCREATITIS - VALUE OF CT IN ESTABLISHING PROGNOSIS
ACUTE-PANCREATITIS - VALUE OF CT IN ESTABLISHING PROGNOSIS
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DOI：
10.1148/radiology.174.2.2296641
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发表时间：
1990-02-01
期刊：
影响因子：
19.7
通讯作者：
RANSON, JHC
中科院分区：
文献类型：
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作者：
BALTHAZAR, EJ;ROBINSON, DL;RANSON, JHC
通过推注造影剂和动态连续计算机断层扫描（CT）对 88 例急性胰腺炎患者进行初次和随访检查，评估胰腺坏死的存在和程度（30%、50% 或大于 50%）。胰腺坏死被定义为全部或部分腺体缺乏增强。对早期或晚期坏死患者（22 名患者）的住院时间、发病率和死亡率进行了评估，并与该组其他患者的相同标准进行比较。坏死患者的死亡率为 23%，并发症发生率为 82%；没有坏死的患者死亡率为 0%，发病率为 6%。仅考虑初步评估时，胰周蜂窝织炎和坏死的患者的发病率为 80%，而有蜂窝织炎且无坏死的患者的发病率为 36%。最初坏死或发展超过 30% 的患者会出现严重并发症。根据最初 CT 研究中观察到的胰周炎症、蜂窝织炎和胰腺坏死程度的组合，制定了 CT 严重程度指数。 CT 严重程度指数高的患者发病率为 92%，死亡率为 17%； CT 严重程度指数较低的患者发病率为 2%，且无人死亡。
The presence and degree of pancreatic necrosis (30%, 50%, or greater than 50%) was evaluated by means of bolus injection of contrast material and dynamic sequential computed tomography (CT) in 88 patients with acute pancreatitis at initial and follow-up examinations. Pancreatic necrosis was defined as lack of enhancement of all or a portion of the gland. Length of hospitalization, morbidity, and mortality in patients with early or late necrosis (22 patients) were evaluated and compared with the same criteria in the rest of the group. Patients with necrosis had a 23% mortality and an 82% complication rate; patients without necrosis had 0% mortality and 6% morbidity. When only the initial assessment was considered, patients with peripancreatic phlegmons and necrosis had 80% morbidity, compared with 36% morbidity in those with phlegmons and no necrosis. Serious complications occurred in patients who initially had or developed more than 30% necrosis. A CT severity index, based on a combination of peripancreatic inflammation, phlegmon, and degree of pancreatic necrosis as seen at initial CT study, was developed. Patients with a high CT severity index had 92% morbidity and 17% mortality; patients with a low CT severity index had 2% morbidity, and none died.