多层螺旋CT联合S-Amy、U-Amy及LPS生化指标检测对急性胰腺炎的诊断价值研究
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摘要
目的探讨多层螺旋CT(MSCT)联合血淀粉酶(S-Amy)、尿淀粉酶(U-Amy)及胰脂肪酶(LPS)对急性胰腺炎的诊断价值。方法取2016年1月至2018年8月我院82例急性胰腺炎患者为研究对象,收集临床及相关影像学资料,分析急性胰腺炎影像图像特征以及不同检查方法对其诊断的灵敏度和特异性。结果 MSCT+SAmy+U-Amy+LPS检查诊断急性胰腺炎的灵敏度和特异性分别为94.6%和93.2%,高于MSCT、S-Amy、U-Amy和LPS四种检查方法各单项、双项以及三项检查(P<0.05);胰腺炎中急性水肿型MSCT平扫表现胰腺体积正常,轮廓清楚或模糊,密度可未见明显改变或轻度降低,部分可见胰周积液和肾前筋膜增厚,增强示病灶呈现均匀强化;急性坏死型平扫胰腺体积明显增大,可见散在点状、斑片状或大片状低密度灶或在密度减低区夹杂密度增高影,胰腺轮廓模糊,增强扫描表现为不均匀强化,坏死区不强化,而正常组织强化。结论 MSCT+SAmy+U-Amy+LPS联合检查对急性胰腺炎的诊断具有较高的灵敏度和特异性,可更清晰的显示胰腺的组织结构,更利于临床进行定性诊断。
Objective To investigate the diagnostic value of multi-slice spiral CT(MSCT combined with detection of biochemical indicator of serum amylase(S-Amy), urinary amylase(U-Amy) and pancreatic lipase(LPS) for acute pancreatitis. Methods 82 patients with acute pancreatitis who were treated in our hospital from January 2016 to August 2018 were included in the study.Clinical and related imaging data were collected to analyze the imaging characteristics of acute pancreatitis and the diagnostic sensitivity and specificity of different examination method. Results The sensitivity and specificity of MSCT combined with S-Amy, U-Amy and LPS for the diagnosis of acute pancreatitis were 94.6% and93.2%, respectively, which were significantly higher than those of the MSCT, S-Amy,U-Amy and LPS alone, and were significantly higher than those of double and triple combination examination of MSCT, S-Amy, U-Amy and LPS(P<0.05).MSCT scan of acute edematous pancreatitis showed that the volume of pancreas was normal, the contour of the pancreas was clear or blurred, there was no significant change or slight decrease in density of pancreas, and peripancreatic effusion and thickening of prerenal fascia partially were seen. Enhanced scan showed uniform enhancement of the lesion. The volume of pancreas in the scan of acute necrotizing pancreatitis can be significantly increased.And it appears as scattered, spotted or large low-density lesions. It also showed area with reduction of density was mingled with shadow of increasing density, with blurred contour. Further enhanced scanning showed uneven enhancement, the necrotic area was not strengthened, and the normal tissue was strengthened. Conclusion Joint examination of MSCT,S-Amy, U-Amy and LPS has higher sensitivity and specificity for the diagnosis of acute pancreatitis, and can clearly show the tissue of pancreas, which is beneficial to clinical qualitative diagnosis.
Objective To investigate the diagnostic value of multi-slice spiral CT(MSCT combined with detection of biochemical indicator of serum amylase(S-Amy), urinary amylase(U-Amy) and pancreatic lipase(LPS) for acute pancreatitis. Methods 82 patients with acute pancreatitis who were treated in our hospital from January 2016 to August 2018 were included in the study.Clinical and related imaging data were collected to analyze the imaging characteristics of acute pancreatitis and the diagnostic sensitivity and specificity of different examination method. Results The sensitivity and specificity of MSCT combined with S-Amy, U-Amy and LPS for the diagnosis of acute pancreatitis were 94.6% and93.2%, respectively, which were significantly higher than those of the MSCT, S-Amy,U-Amy and LPS alone, and were significantly higher than those of double and triple combination examination of MSCT, S-Amy, U-Amy and LPS(P<0.05).MSCT scan of acute edematous pancreatitis showed that the volume of pancreas was normal, the contour of the pancreas was clear or blurred, there was no significant change or slight decrease in density of pancreas, and peripancreatic effusion and thickening of prerenal fascia partially were seen. Enhanced scan showed uniform enhancement of the lesion. The volume of pancreas in the scan of acute necrotizing pancreatitis can be significantly increased.And it appears as scattered, spotted or large low-density lesions. It also showed area with reduction of density was mingled with shadow of increasing density, with blurred contour. Further enhanced scanning showed uneven enhancement, the necrotic area was not strengthened, and the normal tissue was strengthened. Conclusion Joint examination of MSCT,S-Amy, U-Amy and LPS has higher sensitivity and specificity for the diagnosis of acute pancreatitis, and can clearly show the tissue of pancreas, which is beneficial to clinical qualitative diagnosis.
引文
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[3]党云超,许红梅.螺旋CT灌注技术联合生化指标检测在急性胰腺炎诊断及病情评估中的应用研究[J].中国CT和MR I杂志,2 01 8,1 5(6):34 0-342.
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[7]张剑,魏殿军.血淀粉酶、胰脂肪酶、PCT、CRP联合检测在急性胰腺炎中的诊断价值[J].中国实验诊断学,2017,21(5):778-780.
[8]王锦生,徐红波,王维钢.sFlt-1、AMY及LIP联合检测对急性胰腺炎的早期诊断价值[J].国际消化病杂志,2 018,55(2):405-407.
[9]陈翠连,王明林,袁启奎,等.常见生化指标联合检测对急性胰腺炎病情严重程度的评估价值[J].重庆医学,2017,46(31):4402-4404.
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[11]穆峰,王一民,何文进,等.多层CT联合血清淀粉酶、脂肪酶浓度检测在急性胰腺炎诊断中的应用[J].河北医药,2016,38(12):1775-1778.
[12]陈梅,罗莉芸,黄尚书,等.SAA、PCT、hs-CRP和TPS-2联合检测在急性胰腺炎诊断中的价值[J].检验医学与临床,2018,18(14):308-310.
[1 3]党云超,许红梅.螺旋CT灌注技术联合生化指标检测在急性胰腺炎诊断及病情评估中的应用研究[J].中国CT和MRI杂志,2 018,15(6):2 04-206.
[14]陈宏.CT、MRI对急性胰腺炎的诊断价值比较[J].中国CT和MRI杂志,2017,15(5):103-105.
[15]李正亮,杜伟.16排螺旋CT对急性胰腺炎的诊断价值研究[J].临床医药文献电子杂志,2 017,4(38):7442-7443.
[16]付林.64排螺旋CT对急性胰腺炎的诊断分析[J].中国医药指南,2 016,14(21):2 3-24.
[17]王生杰,祁黎梅,齐钧,等.64排螺旋C T与彩超检查对急性胰腺炎及其发病危险因素诊断价值的对比研究[J].卫生职业教育,2 017,35(4):149-151.
[18]Yon-Chao D,Hong-Mei X U.Application of Spiral CT Perfusion Technology Combined with Biochemical Indexes in the Diagnosis and Condition Evaluation of Acute Pancreatitis[J].Chinese Journal of Ct&Mri,2018,5(10):842-844.
[2]朱红梅.急性胰腺炎患者S-Amy、U-Amy、LPS、TAP及CRP水平检测的临床价值评估[J].河北医药,2016,44(1):418-420.
[3]党云超,许红梅.螺旋CT灌注技术联合生化指标检测在急性胰腺炎诊断及病情评估中的应用研究[J].中国CT和MR I杂志,2 01 8,1 5(6):34 0-342.
[4]周小森,王保海,孙静涛,等.螺旋C T灌注技术在急性胰腺炎诊断中的应用研究[J].海南医学院学报,2017,23(6):855-857.
[5]高娟,刘静.急性胰腺炎早期诊断中血清脂肪酶、淀粉酶、C反应蛋白联合检验的临床价值[J].现代消化及介入诊疗,2017,22(3):325-327.
[6]彭卫军.螺旋CT在急性胰腺炎诊断及病情分级中的应用[J].中国CT和MRI杂志,2018,15(2):246-248.
[7]张剑,魏殿军.血淀粉酶、胰脂肪酶、PCT、CRP联合检测在急性胰腺炎中的诊断价值[J].中国实验诊断学,2017,21(5):778-780.
[8]王锦生,徐红波,王维钢.sFlt-1、AMY及LIP联合检测对急性胰腺炎的早期诊断价值[J].国际消化病杂志,2 018,55(2):405-407.
[9]陈翠连,王明林,袁启奎,等.常见生化指标联合检测对急性胰腺炎病情严重程度的评估价值[J].重庆医学,2017,46(31):4402-4404.
[10]Guisheng Z,Ping G,Jing S U.Early Diagnosis ofC-reactive Protein,Amylase and Lipase in Patients With Acute Pancreatitis[J].China Continuing Medical Education,2017,17(2):1826-1828.
[11]穆峰,王一民,何文进,等.多层CT联合血清淀粉酶、脂肪酶浓度检测在急性胰腺炎诊断中的应用[J].河北医药,2016,38(12):1775-1778.
[12]陈梅,罗莉芸,黄尚书,等.SAA、PCT、hs-CRP和TPS-2联合检测在急性胰腺炎诊断中的价值[J].检验医学与临床,2018,18(14):308-310.
[1 3]党云超,许红梅.螺旋CT灌注技术联合生化指标检测在急性胰腺炎诊断及病情评估中的应用研究[J].中国CT和MRI杂志,2 018,15(6):2 04-206.
[14]陈宏.CT、MRI对急性胰腺炎的诊断价值比较[J].中国CT和MRI杂志,2017,15(5):103-105.
[15]李正亮,杜伟.16排螺旋CT对急性胰腺炎的诊断价值研究[J].临床医药文献电子杂志,2 017,4(38):7442-7443.
[16]付林.64排螺旋CT对急性胰腺炎的诊断分析[J].中国医药指南,2 016,14(21):2 3-24.
[17]王生杰,祁黎梅,齐钧,等.64排螺旋C T与彩超检查对急性胰腺炎及其发病危险因素诊断价值的对比研究[J].卫生职业教育,2 017,35(4):149-151.
[18]Yon-Chao D,Hong-Mei X U.Application of Spiral CT Perfusion Technology Combined with Biochemical Indexes in the Diagnosis and Condition Evaluation of Acute Pancreatitis[J].Chinese Journal of Ct&Mri,2018,5(10):842-844.