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急性胰腺炎第一天的胰腺CT平扫中显示的肝脏灌注异常能否提示疾病的预期严重程度?

Can Disturbed Liver Perfusion Revealed in p-CT on the First Day of Acute Pancreatitis Provide Information about the Expected Severity of the Disease?

作者信息

Pieńkowska Joanna, Gwoździewicz Katarzyna, Skrobisz Katarzyna, Czarnowska-Cubała Monika, Kozak Oliwia, Hać Stanisław, Studniarek Michał, Szurowska Edyta

机构信息

II Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.

I Department of Radiology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland.

出版信息

Gastroenterol Res Pract. 2019 Aug 14;2019:6590729. doi: 10.1155/2019/6590729. eCollection 2019.

Abstract

BACKGROUND

The aim of the study was to evaluate the prognostic properties of perfusion parameters of liver parenchyma based on computed tomography (CT) of patients with acute pancreatitis (AP) made on the first day of onset of symptoms, to assess their usefulness in identifying patients with increased risk of the development of severe AP.

METHODS

79 patients with clinical symptoms and biochemical criteria indicative of AP underwent perfusion computed tomography (p-CT) within 24 hours after onset of the symptoms. Perfusion parameters in 41 people who developed a severe form of AP were compared with parameters in 38 patients in whom the course of AP was mild.

RESULTS

Statistical differences in the liver perfusion parameters between the group of patients with mild and severe AP were shown. The permeability-surface area product was significantly lower, and the hepatic arterial fraction was significantly higher in the group of patients with progression of AP.

CONCLUSIONS

Based on the results, it seems that p-CT performed on the first day from the onset of AP is a method that, by revealing disturbances in hepatic perfusion, can help in identifying patients with increased risk of the development of severe AP.

摘要

背景

本研究旨在基于急性胰腺炎(AP)患者症状出现首日的计算机断层扫描(CT)评估肝实质灌注参数的预后特性,以评估其在识别发生重症急性胰腺炎风险增加患者中的作用。

方法

79例有临床症状且生化指标符合AP的患者在症状出现后24小时内接受了灌注计算机断层扫描(p-CT)。将41例发展为重症AP的患者的灌注参数与38例AP病程为轻症的患者的参数进行比较。

结果

轻症和重症AP患者组之间的肝脏灌注参数存在统计学差异。在AP进展组中,通透表面积乘积显著更低,肝动脉分数显著更高。

结论

基于这些结果,似乎在AP发病首日进行的p-CT是一种通过揭示肝脏灌注紊乱来帮助识别发生重症AP风险增加患者的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e59e/6710743/f895daea8680/GRP2019-6590729.001.jpg

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