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胰腺癌术后腹部感染患者的CT表现及特征

CT findings and features of postoperative abdominal infection patients with pancreatic carcinoma.

作者信息

Ma Yuzhuo, Liu Guangsheng, Zhang Lingling

机构信息

Yuzhuo Ma, Radiology Department, Binzhou People's Hospital, Shandong 256610, China.

Guangsheng Liu Radiology Department, Binzhou People's Hospital, Shandong 256610, China.

出版信息

Pak J Med Sci. 2017 May-Jun;33(3):695-698. doi: 10.12669/pjms.333.12355.

DOI:10.12669/pjms.333.12355
PMID:28811797
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5510129/
Abstract

OBJECTIVE

To investigate the values of Computed Tomography (CT) in diagnosing postoperative pancreatic surgeryabdominalinfection and its efficacy and to provide a reasonable method for the diagnosis of abdominal infection.

METHODS

Seventy-two patients who were confirmed as resectablepancreatic carcinoma by physical examination, CT, positron emission tomography (PET)/CT, endoscopic retrograde cholangiopancreatography (ER-CP), endoscopic ultrasonography and mesenteric angiography and were admitted to the Binzhou People's Hospital, Shandong, China, from July 2013 to July 2015 were randomly selected. The plain CT images and clinical data of the patients were retrospectively analyzed.

RESULTS

Among 72 patients, 32 patients were diagnosed as abdominal infection by CT, three patients were misdiagnosed (two cases of intestinal obstruction and one case of intraperitoneal abscess), and 2 patients were wrongly diagnosed as suppurative abdominal inflammation. As regards distribution of CT imaging positive performance, the number of patients with intestinal loop abscess accounted for 41.7%, subphrenic abscess for 16.7%, pelvic abscess for 33.3%, the existence of septation for 25%, and emphysema sign for 16.7%. As to the distribution of CT findings of intestinal obstruction, 46.1% of patients had dilatation of intestine, 30.8% for bowel wall thickening, 7.7% had abnormal enhancement, 11.1% had density abnormality, and 15.4% had mesenteric effusion. CT features of purulent peritonitis showed 57.1% of patients had peritoneal thickening, 42.9% had peritoneal effusion, 42.9% had free intraperitoneal air, 14.3% had intestinal walls edema, and 28.6% had mesenteric edema.

CONCLUSION

The diagnosis of postoperative abdominal infection of patients with pancreatic carcinoma using CT is quick and efficient showing the pattern and distribution of collection and the gross reaction to the exciting infection.

摘要

目的

探讨计算机断层扫描(CT)在诊断胰腺癌术后腹部感染中的价值及其有效性,为腹部感染的诊断提供合理方法。

方法

随机选取2013年7月至2015年7月在中国山东省滨州市人民医院收治的72例经体格检查、CT、正电子发射断层显像(PET)/CT、内镜逆行胰胆管造影(ERCP)、内镜超声及肠系膜血管造影确诊为可切除胰腺癌的患者。回顾性分析患者的CT平扫图像及临床资料。

结果

72例患者中,CT诊断为腹部感染32例,误诊3例(2例肠梗阻、1例腹腔脓肿),2例被误诊为化脓性腹膜炎。CT影像阳性表现分布方面,肠袢脓肿患者占41.7%,膈下脓肿占16.7%,盆腔脓肿占33.3%,存在分隔占25%,气肿征占16.7%。肠梗阻CT表现分布方面,46.1%的患者肠管扩张,30.8%肠壁增厚,7.7%强化异常,11.1%密度异常,15.4%肠系膜积液。化脓性腹膜炎CT表现为57.1%的患者腹膜增厚,42.9%有腹腔积液,42.9%有腹腔游离气体,14.3%肠壁水肿,28.6%肠系膜水肿。

结论

CT诊断胰腺癌患者术后腹部感染快速有效,可显示积液的形态、分布及对感染刺激的大体反应。

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A human clinical trial using ultrasound and microbubbles to enhance gemcitabine treatment of inoperable pancreatic cancer.一项使用超声和微泡增强不可切除胰腺癌吉西他滨治疗的人体临床试验。
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Developing a core set of patient-reported outcomes in pancreatic cancer: A Delphi survey.制定一套胰腺癌患者报告结局的核心指标:德尔菲调查。
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